Presentation
For a long time is a known case of cystic bronchiectasis with recurrent visits by chronic productive cough and recurrent chest infection.
Patient Data
Lung parenchyma shows multiple cystic bronchiectases involving the following :
- Almost the entire left lower lobe ,some of them are showing thick walls and air-fluid levels.
- The medial segment of the right middle lobe to a lesser extent the medial segment of the right lower lobe.these may look like the appearance of a bunch of grapes sign.
Pleura: No pleural effusion, thickening, or pneumothorax.
The chest radiograph shows a cluster of thin and thick-walled cystic spaces involving the left lower lobe and less obvious in the middle lobe. the findings have been confirmed in the above CT chest.
Follow up known status of cystic bronchiectasis post left lower lobectomy.
Evidence of left lower lobectomy post-operative changes with no suspicious lesion at the operative bed. Compensatory hyperinflation of the left upper lobe is observed.
The multiple cystic bronchiectases involving the medial segment of the right middle lobe and to a lesser extent the medial segment of the right lower lobe., have been stable since the last scan. Evidence of air trapping involving the posterior basal segments of the right lower lobe.
The rest of lung parenchyma is normal appearance with no interstitial lines, nodules or ground-glass opacity.
The trachea and the rest visualized branches are unremarkable.
No pleural or pericardial effusion is seen.
Case Discussion
This is a good example case of cystic bronchiectasis and suggests an idiopathic etiology. HRCT chest is the cornerstone in the radiological diagnosis of clinically suspicious cases and typical radiological features of bronchiectasis are seen in our case such as the bunch of grapes sign.
The role of chest x-ray in patients with known bronchiectasis may be reduced to surveillance for infection, lobar collapse or suspected development of cavitary disease.
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