Congenital bronchial atresia presenting as a cavitary lesion on chest radiography: a case report

Abstract

BackgroundCongenital bronchial atresia is a rare anomaly, which usually presents in adulthood as an incidental finding on routine examinations.Case presentationIn this report we present a patient with a cavitary lesion at his right upper lobe, found by chance on chest radiography. Computed tomography of the chest revealed the characteristic findings of a mucocele with distal oligemia and hyperlucency of the affected lung parenchyma. Further examination including bronchoscopy virtually excluded other possible disorders and the diagnosis of congenital bronchial atresia was established.ConclusionThe radiological presentation of congenital bronchial atresia may occasionally mimic serious lung diseases. The procedure of choice for the diagnosis is the computed tomography of the chest. Bronchoscopy is not diagnostic but is valuable in doubtful cases to exclude different disorders.

Unusual Radiological Sign in Bronchial Atresia

“…Generally bronchial mucocele occurs as a result of mucus accumulation in the distal of the the atresic bronchus [7]. Bronchial atresia is usually asymptomatic, just as it was in our case; however, it may cause repetitive lung infection, cough, wheezing, and dyspnea in some cases [8,9]. It has been reported to cause spontaneous pneumothorax very rarely [10].…”

“…The surrounding area of the mucus-filled, widened bronchus is seen hyperlucent with focal parenchymal oligemia and air trapping that occur as a result of hypoxic vasoconstriction and intrapulmonary vascular compression [13]. Bronchoscopy can be used in terms of the diagnosis of proximal atresia and differential diagnosis [8,9]. Mucocele, which is a typical finding of bronchial atresia on lung graphy, can be seen as nodule close to the hilar region, ovoid, bronchus structure or tubular [14].…”

Bronchocele: Two Cases

“…It has a male predominance. The estimated prevalence is 1.2 cases per 100,000 males [10]. The patients are generally asymptomatic and the disease is diagnosed coincidentally at the second or third decades.…”

“…In differential diagnosis of cystic lesions of lungs; congenital abnormalities (pulmonary sequestration, bronchogenic cyst and bronchocele), tumoral masses (primary pulmonary mucinous adenocarcinosis or pulmonary metastasis of it) should be necessarily kept in mind. Bronchoscopically, blind ending may be demonstrated at the atresic bronchus yet it may be normal as well [10]. Bronchoscopy is also recommended for patients with bronchial atresia in literature in order to exclude other possible pathologies [4,12,13].…”

Lung Diseases - Selected State of the Art Reviews

“…When the hyperinsuflated area gets infected and presents as a pneumonia, the walls of bronchoceles develop tiny breaks that enables the air to enter in its lumen (Psathakis et al, 2009;Rahalkar et al, 2005).…”