Westcott J L, Cole S R
Radiology. 1986 Dec;161(3):665-9. doi: 10.1148/radiology.161.3.3786716.
Postmortem examination of the lungs of 12 patients with end-stage pulmonary fibrosis revealed the frequent (nine of 12) presence of bronchiectasis. The segmental and subsegmental bronchi were dilated, tortuous, and had a convoluted appearance that resembled a string of pearls. Bronchiectasis was confined to areas of advanced fibrosis. When fibrosis was mild or when it was combined with emphysema, bronchiectasis was absent or mild. Specimen radiographs revealed that bronchiectasis frequently contributed to the radiographic appearance of honeycombing. Retrospective analysis of the plain chest radiographs obtained from five of the patients revealed evidence suggestive of bronchiectasis, but bronchiectasis was difficult to detect unless the surrounding lung was radiopaque. In two living patients with end-stage pulmonary fibrosis, bronchiectasis was much better depicted on computed tomography scans than on plain chest radiographs. In patients with pulmonary fibrosis, the presence of bronchiectasis does not necessarily imply the presence of primary bronchial disease. Rather, bronchiectasis can be a direct result of the fibrotic process.
对12例终末期肺纤维化患者的肺部进行尸检发现，支气管扩张很常见（12例中有9例）。肺段和亚段支气管扩张、扭曲，呈盘绕状，类似一串珍珠。支气管扩张局限于晚期纤维化区域。当纤维化较轻或合并肺气肿时，支气管扩张不存在或较轻。标本X线片显示，支气管扩张常导致蜂窝状的影像学表现。对其中5例患者的胸部平片进行回顾性分析发现有提示支气管扩张的证据，但除非周围肺组织不透光，否则支气管扩张很难检测到。在2例终末期肺纤维化的活体患者中，计算机断层扫描比胸部平片更能清晰显示支气管扩张。在肺纤维化患者中，支气管扩张的存在不一定意味着存在原发性支气管疾病。相反，支气管扩张可能是纤维化过程的直接结果。
