Lung - nontumor
Chronic obstructive pulmonary disease (COPD)
Bronchiectasis

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 22 February 2017, last major update August 2011

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: bronchiectasis [title] lung

Cite this page: Bronchiectasis. PathologyOutlines.com website. http://pathologyoutlines.com/topic/lungnontumorbronchiectasis.html. Accessed September 26th, 2017.
Definition / general
  • Permanent dilation of bronchi and bronchioles caused by destruction of mucosal and elastic tissues, caused by or associated with chronic necrotizing infection of bronchi and bronchioles
Pathophysiology
  • Obstruction (due to tumor, foreign body, inspissated mucus) causes resorption of air distal to obstruction, atelectasis and accumulation of intraluminal secretions
  • Nonobstructive bronchiectasis is due to pneumonia and atelectasis, which increases negative, intrapleural pressure, which exerts an external force on bronchial walls, causing them to dilate; usually left sided affecting lower lobes
Clinical features
  • Diagnosis is based on presence of infection (stasis occurs in dilated bronchi) and obstruction
  • Patients have significant morbidity
  • 9% prevalence in Korean study; associated with TB (Tohoku J Exp Med 2010;222:237)
  • Symptoms: cough, fever and copious amounts of foul smelling, purulent sputum
  • Causes: bronchial obstruction (localized bronchiectasis), congenital bronchiectasis, cystic fibrosis, intralobar sequestration of lung, immunodeficiency, immotile cilia / Kartegener syndrome, Young syndrome, necrotizing pneumonia (staphylococcus, tuberculosis)
  • Cystic fibrosis: obstruction due to mucus plugs, infection due to decreased ciliary clearance of bacteria
  • Kartegener syndrome: autosomal recessive condition with variable penetrance; due to absent or irregular dynein arms of cilia, which causes defective bacterial clearance (bronchiectasis, sinusitis), defective cell motility during embryogenesis (situs inversus) and immotile sperm (infertility)
  • Young syndrome: infertility caused by azoospermia, but without ultrastructural ciliary abnormalities
Treatment
Gross description
  • Markedly distended peripheral bronchi, usually in lower lobes, can trace to pleural surface; bronchial walls are irregularly thickened
Gross images

Images hosted on other servers:

Various images

Microscopic (histologic) description
  • Chronic inflammation, ulceration of bronchial wall, ossification of bronchial cartilage, thickened pleura
  • Variable inflammation and fibrosis of alveoli
Microscopic (histologic) images

Images hosted on other servers:

Dilated bronchus with necrotizing inflammation and destruction

Various images