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DR Medhat MRCP

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Subtypes<br />

a) Cylindrical (bronchi have a uniform calibre, do not taper and have parallel walls)<br />

b) Varicose (uncommon)<br />

c) Cystic (with air-fluid level in erect position).<br />

Investigations :<br />

1- CXR :<br />

- It`s not always abnormal.<br />

- “Tram-track opacities” parallel thickened lines represent dilated thick bronchial<br />

Wall , seen in cylindrical type<br />

- Prominent bronchovascular markings with characteristic reticulonodular shadows<br />

forming “Honeycomb appearance” , seen in cystic type .<br />

2- HRCT :<br />

- Classic “signet ring” appearance ie enlarged bronchus & neighbouring vessels<br />

- “honeycombing”<br />

- A central (perihilar)distribution suggest ABPA & upper lobe distribution suggest<br />

cystic fibrosis.<br />

3- PFT : obstructive pattern .<br />

4- ABG: hypoxia &/or hypercapnoea in advanced disease.<br />

5- Sputum C/S : Most common organisms isolated from patients with bronchiectasis:<br />

Haemophilus influenzae (most common)<br />

Pseudomonas aeruginosa<br />

Klebsiella spp.<br />

Streptococcus pneumoniae<br />

6- Bronchoscopy : to R/O FB, mucous blug or tumour/trachea &bronchi.

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