Gupta Pankaj, Prakash Mahesh, Aggarwal Ashutosh Nath, Khandelwal Niranjan
Department of Radiodiagnosis and Imaging & Department of Respiratory Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.
Lung India. 2015 May-Jun;32(3):278-80. doi: 10.4103/0970-2113.156254.
Abnormal bronchi arising from trachea and main bronchi are rare and usually clinically silent. These bronchial variations, however, pose a significant diagnostic challenge related to their variable presentation and perhaps the low level of awareness among clinicians and radiologists. Complications including recurrent infections, hemoptysis, and rarely malignancies may arise, if the diagnosis is delayed. We came across a patient with chronic cough in whom endoscopic and imaging evaluation, including fine-needle aspiration cytology (FNAC), proved non-diagnostic. Thorough evaluation of multidetector computed tomography (MDCT) performed in our department, however, revealed an accessory cardiac bronchus with rudimentary lung parenchyma in the paracardiac location. This case highlights the importance of meticulous airway evaluation on MDCT in all patients referred with respiratory symptoms.
起源于气管和主支气管的异常支气管较为罕见，通常在临床上无明显症状。然而，这些支气管变异因其表现多样，且临床医生和放射科医生对此的认知程度可能较低，给诊断带来了重大挑战。如果诊断延迟，可能会出现包括反复感染、咯血以及罕见的恶性肿瘤等并发症。我们遇到一名慢性咳嗽患者，经内镜检查和影像学评估，包括细针穿刺抽吸细胞学检查（FNAC），均未能明确诊断。然而，在我们科室进行的多排螺旋计算机断层扫描（MDCT）的全面评估显示，在心旁位置存在一个伴有发育不全肺实质的副心支气管。该病例凸显了对所有有呼吸道症状转诊患者进行MDCT细致气道评估的重要性。
