BRONCHIECTASIS

Bronchiectasis

Bronchiectasis

It is defined as abnormal & irreversible dilatation of bronchi & bronchioles(>2mm in diameter) develop secondary to weakening of bronchial wall. Mostly persistent cough with expectoration of copious amount with foul smell purulent sputum is common clinical feature.

Etiopathogenesis:- Inflammatory destructive process is always result of endobronchial obstruction by foreign body, enlarge lymph nodes, neoplastic growth causes resorption of air distal to the obstruction with consequent atelectasis.

And secondary to local obstruction which  causes infection &  impaired defense mechanism promote bacterial growth.

Morphological features:- It affect distal bronchi & bronchioles beyond segmental bronchi.

Grossly, the lungs may be involved diffusely or segmentally. The pleura is fibrotic & thickened with adhesion to the chest wall. Dilated airway have been classified as:-

    • Cylindrical- Characterised by tube like bronchial dilation found frequently.
    • Fusiform– Spindle shaped.
    • Saccular– Rounded sac like.
    • Varicose– Having irregular enlargements

Cut surface of affected lobe generally lower, shows honey- combed appearance & the bronchi lumina filled with mucus pus.

Microscopically, bronchial epithelium may be normal, or show squamous metaplasia.

  • Bronchial wall shows infiltration by acute or chronic inflammatory cells , destruction of normal muscle , fibrosis & bands of fibrous tissues between bronchus & pleura.

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