Presentation
Known asthmatic presents with breathlessness for 1 week.
Patient Data
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