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Diffuse panbronchiolitis

Case contributed by Dr Muthu Magesh


Known asthmatic presents with breathlessness for 1 week.

Patient Data

Age: 50 years
Gender: Male

Normal chest x-ray. 


Bronchial dilatation with signet ring appearance in both upper and lower lobes bronchi on both sides.

Branching centrilobular nodules extending to small branching linear areas of attenuation seen diffusely in both lungs, few in the subpleural secondary pulmonary lobules.

Case Discussion

Panbronchitis most commonly occurs in the middle-aged Asian population. On high-resolution CT, centrilobular opacities with branching lines (tree-in-bud pattern), bronchiolectasis, and bronchiectasis are seen.

CT findings in bronchitis are divided into direct and indirect signs:

  • direct: bronchial wall thickening by inflammatory cells results in centrilobular nodules in the form of V and Y shaped patterns; bronchiolectasis in chronic forms of bronchiolitis seen in the pleural surface
  • Indirect sign: mosaic attenuation with air trapping; air trapping is usually seen, but in diffuse cases, the mosaic attenuation may not be appreciated.

Types of bronchitis

  • inflammatory, which includes infectious, hypersensitivity pneumonitis, respiratory bronchitis, follicular, panbronchitis, and bronchiectasis
  • constrictive fibrotic type
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Case information

rID: 78340
Published: 10th Jun 2020
Last edited: 15th Jun 2020
System: Chest
Inclusion in quiz mode: Included

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