Bronchiectasis

Alvaro C. Laga

Timothy C. Allen

Philip T. Cagle

Bronchiectasis refers to the irreversible pathologic dilation of bronchi due to inflammation and fibrosis, most often associated with chronic infection. There are many underlying predisposing conditions, including airway obstruction (tumors, foreign bodies, mucous plugs), cystic fibrosis, Kartagener syndrome, and immune deficiency. The lower lobes are more commonly involved.

Histologic Features

Varying degrees of inflammation, ulceration, and squamous metaplasia may be present within dilated bronchi.
Lymphoid follicles are frequently observed in the bronchial walls.
Extensive destruction of the bronchial wall including cartilage, muscle, and submucosal glands.
Fibrosis and inflammation of the bronchial wall and peribronchial tissues.
Associated acute and chronic pneumonias, organizing pneumonia, and postobstructive fibrosis and inflammation.

Figure 57.1 Gross figure of bronchiectasis showing dilated infected segmental bronchi and fibrosis of surrounding lung parenchyma.

Figure 57.2 Bronchus with squamous metaplasia, mucosal erosion, granulation tissue, chronic inflammation, and fibrosis.

Figure 57.3 Honeycomb lung due to bronchiectasis consists of residual spaces lined by metaplastic columnar epithelium within severe fibrosis with smooth muscle hyperplasia.

Figure 57.4 Severe fibrosis due to bronchiectasis with residual spaces lined by metaplastic squamous epithelium with lipidladen macrophages within a residual space.

Only gold members can continue reading. Log In or Register to continue