What are the pathophysiologic characteristics of bronchiectasis?

Updated: Jul 23, 2019
  • Author: Ethan E Emmons, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

In 1950, Reid characterized bronchiectasis as cylindrical, cystic, or varicose in nature. [1] Cylindrical bronchiectasis involves diffuse mucosal edema, with resultant bronchi that are dilated but have straight, regular outlines that end squarely and abruptly (see the image below).

Cylindrical bronchiectasis with signet-ring appear Cylindrical bronchiectasis with signet-ring appearance. Note that the luminal airway diameter is greater than the diameter of the adjacent vessel.

Cystic or saccular bronchiectasis has ulceration with bronchial neovascularization. The result is a ballooned appearance and sometimes air-fluid levels (see the image below).

Cystic and cylindrical bronchiectasis of the right Cystic and cylindrical bronchiectasis of the right lower lobe on a posterior-anterior chest radiograph.

Varicose bronchiectasis has a bulbous appearance with a dilated bronchus and interspersed sites of relative constriction and, potentially, obstructive scarring. The latter may subsequently result in postobstructive pneumonitis and additional parenchymal damage (see the image below).

Varicose bronchiectasis with alternating areas of Varicose bronchiectasis with alternating areas of bronchial dilatation and constriction.

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