BRONCHIECTASIS

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

Etiopathogenesis

– The inflammatory destructive process always results of endobronchial obstruction by a foreign body, enlarge lymph nodes, neoplastic growth causes resorption of air distal to the obstruction with consequent atelectasis.

-Secondary to the local obstruction which causes infection &  impaired defense mechanism promotes bacterial growth.

Morphological features

It affects 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 honeycombed appearance & the bronchi lumina filled with mucus pus.

Microscopically-

-Bronchial epithelium may be normal or show squamous metaplasia.

-The 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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