Definition: Is a chronic necrotising infection of the bronchi and bronchioles leading to or associated with abnormal dilation of these airways. Prevalence: * 1.5 per 1000 population * Has decreased in recent times CSBRP-Dec-2012
Clinical features Cough, fever, copious foul smelling sputum The dilation is permanent. Reversible dilation occurs in viral and bacterial pneumonia. CSBRP-Dec-2012
NORMAL CILIARY DYSKINESIA DYNEIN ARM CSBRP-Dec-2012
Commonest abnormalities: Absence of either outer or inner dynein arms Defects in radial spokes etc. CSBRP-Dec-2012
Clinical features of Ciliary dyskinesia: Repeated bouts of otitis & sinusitis Recurrent chest infections Situs inversus - [ 50% ] [ Kartagener syndrome - triad ] Males --- Infertility CSBRP-Dec-2012
Kartagener’s syndrome1. Bronchiectasis2. Situs inversus3. Sinusitis4. Infertility in menCharacterised by ultrastructural changes in microtubules causing immotility of cilia of respiratory epithelium, sperms. CSBRP-Dec-2012
Pathogenesis: Thick mucus Obstruction to the bronchus Infection CSBRP-Dec-2012
Morphology - Gross Affects lower lobes Bilateral Air passages that are vertical Tumor/FB aspiration – localized single segment Severe involvement - more distal bronchi Airways are 4x dilated than normal CSBRP-Dec-2012
This is a bronchogram that demonstrates saccular bronchiectasis on the right in the lower lobe. The contrast media fills dilated bronchi, giving a saccular, dilated outline.CSBRP-Dec-2012
Dilatation of Bronchi & Bronchioles 2cms CSBRP-Dec-2012
Bronchiectasis, secondary to obstruction involving the right middle lobe.CSBRP-Dec-2012
A closer view of the lung demonstrates the focal area of CSBRP-Dec-2012 dilated bronchi typical of bronchiectasis.
Fig15-3 Bronchiectasis in a patient with cystic fibrosis, who underwent lung transplantation. Cut surface of lung shows markedly distended peripheral bronchi filled with mucopurulent secretions.CSBRP-Dec-2012
Bronchiectasis is seen here. The repeated episodes of inflammation can result inscarring, which has resulted in fibrous adhesions between the lobes. Fibrous pleuraladhesions are common in persons who have had past episodes of inflammation of thelung that involve the pleura. With extensiveCSBRP-Dec-2012 the pleural space may be involvement,obliterated.