How does anatomical distribution bronchiectasis aid in the identification of underlying etiology?

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

The anatomical distribution of bronchiectasis may be important in helping diagnose any associated condition or cause of bronchiectasis, as follows:

  • Bronchiectasis as a result of infection generally involves the lower lobes, the right-middle lobe, and the lingula

  • Right-middle lobe involvement alone suggests right-middle lobe syndrome, an anatomic dysfunction, or a neoplastic cause with secondary mechanical obstruction

  • Bronchiectasis caused by cystic fibrosis (CF), Mycobacterium tuberculosis infection , or chronic fungal infections tends to affect the upper lobes, although this is not universal in CF

  • Allergic bronchopulmonary aspergillosis (ABPA) also affects the upper lobes but usually involves the central bronchi, whereas most other forms of bronchiectasis involve distal bronchial segments


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