- Mucoid impaction from accumulated inspissated secretions within the bronchial lumen. Usually associated with bronchial dilatation.
- Associated with bronchial obstruction – neoplasm, adenoma and atresia.
- Associated without bronchial obstruction – asthma, cystic fibrosis and infection.
- Variable symptoms including shortness of breath, cough, purulent sputum and haemoptysis. Some patients may be asymptomatic (e.g. bronchial atresia).
- There may be history of chronic illness.
- CXR – the lesion may be solitary or multiple, often measuring in excess of 1 cm in diameter with branching ‘fingers’ extending towards the periphery, the so-called gloved finger shadow. Theremay be air trapping and lucency distal to the bronchocele. Sometimes the obstructing lesion produces lung collapse, making it impossible to identify the bronchocele on CXRs.
- CT – confirms the plain film changes with dilated mucus-filled bronchi
- distal air trapping. The CT is very good for identifying obstructing neoplastic masses and demonstrating bronchoceles in a region of lung collapse.
- The different potential causes of bronchoceles. A good clinical history coupled with cross-sectional imaging is usually diagnostic.
- Removal of the obstructing lesion may be necessary. Bronchoscopy is a useful way of removing large mucus plugs and obtaining a tissue diagnosis from neoplastic masses.
- Non-obstructing lesions require physiotherapy and antibiotic administration.