Cavities

System : Cardiopulmonary Imaging
Modality : Conventional Radiography, CT
System : Cardiopulmonary Imaging

emphysema?

Patient History
Shortness of breath and productive cough
Patient Age: 31
Patient Gender: Male
Patient Age: 31
Patient Gender: Male
Modality:
Conventional Radiography, CT
Findings
X ray: The lung parenchyma demonstrates multi thin-walled cystic cavities with air fluid levels and emphysematous changes located centrally, predominantly in the middle and lower lobe more affecting the left side. CT: Evidence of cystic bronchiectasis involving the posterior aspect of the left Upper lobe and anterior left lower lobe. Some of the cysts demonstrate air fluid levels. There is associated bilateral emphysema.
Case Discussion
Causes As is true for most lung pathology, bronchiectasis is the common response of bronchi to many different insults. Causes include: • post-infective (most common) ◦necrotising bacterial pneumonia. ◦granulomatous disease. ◦allergic bronchopulmonary aspergillosis (ABPA). ◦measles. • congenital ◦congenital cystic bronchiectasis ◦cystic fibrosis (CF). ◦ciliary dysfunction syndromes. ◦bronchial cartilage deficiency. ◦abnormal lung. ◦abnormal physiology. ◦Mounier-Kuhn syndrome. • bronchial obstruction ◦malignancy. ◦inhaled foreign bodies. ◦chronic aspiration lung changes. • loss of surrounding lung volume ◦traction bronchiectasis. • others ◦ rheumatoid arthritis. ◦ systemic lupus erythematosus (SLE). ◦post radiotherapy. ◦post-transplantation. Mnemonic to remember common causes: CAPT KANGAROO HAS MOUNIER KUHN. Types: According to macroscopic morphology, three types have been described, which also represent a spectrum of severity: • cylindrical bronchiectasis ◦bronchi have a uniform calibre, do not taper and have parallel walls (tram track sign and signet ring sign). ◦commonest form. • varicose bronchiectasis ◦relatively uncommon. ◦beaded appearances where dilated bronchi have interspersed sites of relative narrowing. • cystic bronchiectasis ◦severe form with cyst-like bronchi that extend to the pleural surface ◦air-fluid levels are commonly present.
Questions For Case
  • Q:Signs discribes on CT:
    SHOW ANSWER
    A.•tram-track sign - •signet ring sign - string of pearls sign - cluster of grapes sign
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