Presentation
Left sided acute chest pain with mild dyspnea while brushing her hair. No history of respiratory disease.
Patient Data
Mild left-sided pneumothorax with some irregularity of the pleural surface.
A five weeks control showed complete resolution of the spontaneous pneumothorax.
Hyperinflation of the left superior segment with a dilated and atresic bronchius and a mucoid impaction (bronchocele formation). There is also a decrease of the vascularity in the affected lung segment.
The bronchocele is seen in the sagital reconstruction (yellow arrow) and the air trapping and the focal parenquima oligemia are better seen in the minIP and MIP reconstructions respectively.
Case Discussion
Bronchial atresia is a rare congenital pulmonary abnormality that occurs due to the interruption of a lobar, segmental, or subsegmental bronchus. Most of the cases are asymptomatic, being discovered incidentally. In symptomatic patients, recurrent infections are the most common, with spontaneous pneumothorax being an atypical presentation, rarely reported in the literature. Classically on imaging (radiographs and CT), it appears as a rounded or tubular opacity due to mucosal impaction in the interrupted bronchus (bronchocele) surrounded by an area of less attenuation attributable to air trapping and oligohemia due to hypoxic vasoconstriction. CT is the most sensitive method and its findings are typical, considered diagnostic in most cases.
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