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Related Experiment Videos

Bronchial impaction in lobar collapse: CT demonstration and pathologic correlation.

H S Glazer1, D J Anderson, S S Sagel

  • 1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.

AJR. American Journal of Roentgenology
|September 1, 1989
PubMed
Summary

Bronchial impaction, the buildup of mucus in bronchi, can cause lobar collapse. CT imaging reveals this unique pattern, often indicating an underlying obstructing lesion like lung cancer.

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Area of Science:

  • Radiology
  • Pulmonology
  • Pathology

Background:

  • Bronchial impaction involves mucus accumulation in bronchi, potentially leading to bronchial dilatation and lobar collapse.
  • Causes include abnormal mucociliary transport, excessive mucus production, or discrete obstructing lesions.
  • Recognizing bronchial impaction on CT is crucial for diagnosing underlying causes.

Purpose of the Study:

  • To describe the CT manifestations of bronchial impaction in patients with lobar collapse.
  • To correlate CT findings with pathological examination in resected cases.

Main Methods:

  • Retrospective review of CT scans in four patients with lobar collapse and bronchial impaction.
  • Postcontrast CT images were analyzed for specific patterns.
  • Pathological examination of surgically resected lobes.

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Main Results:

  • CT showed impacted bronchi as low-attenuation branching structures within opaque, atelectatic lung.
  • Two patients had bronchogenic carcinoma causing obstruction and impaction.
  • Two patients had mucus accumulation without a discrete obstruction.
  • Pathology confirmed dilated bronchi filled with mucus, exudate, or fungal elements.

Conclusions:

  • Bronchial impaction within a collapsed lobe presents a distinct CT pattern.
  • This pattern necessitates a thorough search for central obstructing lesions, such as lung cancer.