Suspected Right Lower Lobe Bronchiectasis

1. ‫الرحيم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬
Suspected Bronchiectasis
of the Right Lower Lobe
Prof. Abdulsalam Y Taha
College of Medicine
University of Sulaimani
2022
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2. The Case
 A 25-years old lady was admitted to
Sulaymaniyah Teaching Hospital,
Sulaymaniyah, Iraq on the 20th of
June 2009 because of chronic
productive cough of 7 years duration
associated with bouts of fever and
shortness of breath (SOB). CXR
revealed an opacity of the right
lower pulmonary zone (RLZ).
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5. CT scan showed consolidation of
the right lower lobe (RLL).
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7. Fiberoptic bronchoscopy revealed thick offensive pus
from RLL bronchi associated with a tumor-like tissue.
Bronchial wash for AFB was negative as well as
bronchial wash cytology. 7

8. 8

9. The patient responded very well to
conservative treatment.
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10. Follow up
 Thereafter, the patient used to consult us
as an outpatient with episodes of cough
that had a variable response to medical
treatment. A repeat CXR showed cystic
changes in the RLZ and a repeat
bronchoscopy showed the same
inflammatory changes in the RLL bronchus.
A diagnosis of bronchiectasis of RLL was
suspected and accordingly she was advised
for exploratory thoracotomy and RL
Lobectomy. 10

11. Comment
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 Chronic cough has many etiologies.
Besides bronchiectasis, we have to
think of pulmonary tuberculosis which
can simulate any pathology of the
chest. Moreover, tumors and bronchial
obstruction by missed foreign bodies
have to be considered as well.
Resection of the chronically diseased
RLL in this lady is both diagnostic and
therapeutic.