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Bronchiectasis

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Bronchiectasis

Bronchiectasis is a disease in which destruction of smooth muscle and elastic tissue by chronic necrotizing infection leads to permanent dilation of bronchi and bronchioles. Nowadays bronchiectasis is not common because of better control of lung infections.

It may still develop in association with;

  • Congenital or hereditary conditions; cystic fibrosis, immunodeficiency states etc.
  • Infections; bacteria, virus, fungi
  • Bronchial obstruction; tumor, mucus impaction, foreign body etc.
  • Other conditions; rheumatoid arthritis, eryhtematosus, COPD etc.
  • One fourth to one half of the cases are idiopathic.

 

Pathogenesis

Obstruction and infection pooling of the secretions distal to the obstruction and secondary infection

Severe infection inflammation with necrosis, fibrosis, dilation of airways

 

 

Morphology

Bronchiectasis usually affects lower lobes bilaterally, most severe in the more distal bronchi and bronchioles.

When tumor is a causative agent the localization may be on a single segment only.

The airways are dilated, sometimes up to four times.

Bronchiectasis

 

Histologic findings vary associated with chronicity and activity of the disease.

In full-blown, active case there is an intense acute and chronic inflammatory exudation within the walls of bronchi and bronchioles, associated with desquamation of the lining epithelium and extensive areas of the ulceration.

May be pseudostratification of the columnar cells

May be squamous metaplasia

Fibrosis

May be abscess – may be

 

Clinical

Cough

Foul smelling expectoration

Dyspnea

Orthopnea Hemoptysis Cough paroxysms in the morning due to pus collection and secretions drain.

 

 

References


 Robbins & Cotran Pathologic Basis of Disease; 683

Wikipedia

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About The Author
Kadir Timuçin Güneren
Kadir Timuçin Güneren

F*** the medicine!

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