Traction bronchiectasis in end-stage pulmonary fibrosis.

Abstract

Postmortem examination of the lungs of 12 patients with end-stage pulmonary fibrosis revealed the frequent (nine of 12) presence of bronchiectasis. The segmental and subsegmental bronchi were dilated, tortuous, and had a convoluted appearance that resembled a string of pearls. Bronchiectasis was confined to areas of advanced fibrosis. When fibrosis was mild or when it was combined with emphysema, bronchiectasis was absent or mild. Specimen radiographs revealed that bronchiectasis frequently contributed to the radiographic appearance of honeycombing. Retrospective analysis of the plain chest radiographs obtained from five of the patients revealed evidence suggestive of bronchiectasis, but bronchiectasis was difficult to detect unless the surrounding lung was radiopaque. In two living patients with end-stage pulmonary fibrosis, bronchiectasis was much better depicted on computed tomography scans than on plain chest radiographs. In patients with pulmonary fibrosis, the presence of bronchiectasis does not necessarily imply the presence of primary bronchial disease. Rather, bronchiectasis can be a direct result of the fibrotic process.

Non-CF bronchiectasis: does knowing the aetiology lead to changes in management?

“…Idiopathic bronchiectasis has been reported to be predominantly basal in distribution [31]. Bronchiectasis secondary to PCD is often said to involve the middle lobe [32].…”

Thoracic high‐resolution computed tomographic findings in dogs with canine idiopathic pulmonary fibrosis

“…It may result from chronic infection, airway obstruction, inherited bronchial abnormalities or fibrosis. In humans, traction bronchiectasis is a specific HRCT category where the bronchiectasis arises through traction on the bronchial wall by surrounding fibrous tissue (Westcott andCole 1986, Webb andothers 2001). Interestingly, bronchiectasis was not identified on bronchoscopy or standard thoracic radiographs in these two dogs.…”

Comparison of pulmonary thin section CT findings and serum KL-6 levels in patients with sarcoidosis

“…Traction bronchiectasis and architectural distortion are considered to represent the organisation and fibrosis of the lungs around the bronchi [26,28]. Our results showed that increased KL-6 levels in sarcoidosis patients whose CT scans consisted of ground-glass attenuation, architectural distortion or traction bronchiectasis may have been caused by an increase in KL-6 production by regenerating alveolar Type II pneumocytes and/or an enhanced permeability following the destruction of the air-blood barrier in the affected lungs.…”