Postinfectious bronchiectasis

Case contributed by Prashant Mudgal
Diagnosis certain

Presentation

Known pulmonary tuberculosis, did not receive a full course of chemotherapy. Presented with productive cough and dyspnea.

Patient Data

Age: 55 years
Gender: Female
  • A large lobulated heterogeneously enhancing conglomerate lymph nodal mass with peripheral calcification and central necrosis is seen in left paratracheal region.
  • There are enlarged precarinal and subcarinal lymph nodes.
  • Cystic bronchiectatic changes are seen in superior and inferior lingular, anteromedial basal segments of left lung, medial basal segment of right lung and bilateral superior basal and posterior segments.
  • Multiple nodular branching infiltrates are seen in bilateral superior basal segments.
    Above findings are associated with mosaic attenuation in bilateral lung fields.
  • Incidentally noted right sided goiter.
  • Altogether the observed bilateral lower lobe cystic bronchiectasis  is suggestive of sequelae of an infective etiology. the tree in bud pattern in bilateral superior basal segments and mediastinal lymphadenopathy is suggestive of endobronchial spread of active infection.

Case Discussion

Bronchiectasis is irreversible dilatation of the bronchial tree and associated with variety of conditions. One of the most common causes is chronic respiratory tract infection. Mosaic attenuation is frequently associated with bronchiectasis and represents obliterative pattern.

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