Bronchocele, a common but underrecognized condition: a systematic review

Abstract

Bronchocele is an abnormal accumulation of mucus often with associated bronchial dilatation. It can be due to either increased production or impaired drainage of mucus in the airways. Diseases like chronic bronchitis, bronchial asthma, bronchiectasis are characterized by high mucus production and other atypical conditions are bronchorrhea and plastic bronchitis with different physical characteristics and compositions of mucus. Improper drainage can lead to bronchocele formation due to underlying benign, malignant tumours or bronchial stenosis. Allergic bronchopulmonary aspergillosis (ABPA) has a peculiar appearance with high attenuated mucus (HAM) in imaging. Careful evaluation of bronchocele is needed as it can be associated with bronchial obstruction or rare causes like plastic bronchitis. Proper identification, evaluation for the underlying cause is key for not missing the underlying diagnosis and accurate treatment.

Lobar Mucus Plugging Reflecting Central Bronchial Tumoral Obstruction: A Case Report

“…CT chest is of course the investigation of choice for mucus plugging, but indirect signs on chest X-rays can be appreciated as described in our case. Branching opacities and "finger in glove" appearance, characterized by branching tubular or fingerlike opacities that often originate from the hila and are directed peripherally, are classical findings [5,8]. Another important sign that we present in this case is the widening of the RPS.…”

“…The Fleischner Society of glossary defines the bronchocele as a bronchial dilatation due to retained secretions (mucus impaction), usually caused by a proximal congenital or acquired obstruction, with or without an underlying bronchial dilatation [4]. The two main mechanisms leading to an excessive accumulation of mucus are excessive or abnormal production of mucus and impaired drainage [5]. There are many different causes of mucus plugging that can be divided into two groups of conditions.…”

“…First, those that involve bronchial obstruction like neoplasms, foreign bodies, congenital bronchial atresia, broncholithiasis, and tuberculosis. Secondly, those that do not involve bronchial obstruction, like asthma, cystic fibrosis, and allergic bronchopulmonary aspergillosis (ABPA) [5]. Cystic fibrosis is a genetic disorder characterized by a defect in the chloride transporter.…”

“…The mucoid impaction usually involves the upper lobes and, in a few cases, the lower lobes only [6]. ABPA is also characterized by high-attenuation mucus in up to 20% of patients [5,6]. Congenital bronchial atresia is another rare cause of unilobar mucoid impaction and affects mostly the apical posterior segment of the left upper lobe [7].…”

Distinguishing Bronchial Carcinoid from Benign Bronchocele using 68Ga-DOTATOC PET/CT Imaging

“…These tumors display various clinical, morphological, and biological patterns (1). Bronchial carcinoids may exhibit concurrent bronchocele in proximity(2). Bronchoceles, also termed bronchial mucocele, are typically benign but may masquerade as part of the primary tumor, leading to disease upstaging(2).…”