Mounier-Kuhn syndrome: a rare cause of bronchial dilation.
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Mounier-Kuhn syndrome, or tracheobronchomegaly, is a rare clinical and radiologic condition characterized by marked tracheobronchial dilation and recurrent lower respiratory tract infections. Diagnosis is typically accomplished with the use of computed tomography and bronchoscopy, as well as pulmonary function testing. Patients may be asymptomatic; however, symptoms can range from minimal with preserved lung function to severe respiratory failure. Therapy, if any, is supportive but minimal. Surgery rarely has a place in the treatment of Mounier-Kuhn syndrome.Herein, we report the case of a 58-year-old man with chronic obstructive pulmonary disease who had a chronic cough, increased sputum production, and chest pain. Thoracic computed tomography showed tracheal dilation (diameter, 34 mm) and multiple diverticula in the posterior region of the trachea. Fiberoptic bronchoscopy revealed enlarged main bronchi, the dilated trachea, and prominent tracheal diverticula. Pulmonary function testing disclosed impaired respiratory function. Histopathologic examination of biopsy specimens from the bronchi and the tracheal wall supported the diagnosis of Mounier-Kuhn syndrome. The patient was released from the hospital and his condition was monitored for 2 years, during which time he developed no lower respiratory tract infections.Regardless of radiologic findings that suggest recurrent lower respiratory tract infection, we recommend that Mounier-Kuhn syndrome be considered in the differential diagnosis. (+info)
Pericardial fat pad tissue produces angiogenic factors for healing the bronchial stump.
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Comparison of thin section computed tomography with bronchography for identifying bronchiectatic segments in patients with chronic sputum production.
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Computed tomography is widely used in the investigation of patients in whom bronchiectasis is suspected, despite considerable variation in its reported sensitivity and specificity. The findings with 3 mm high resolution computed tomography were compared at segmental level with bronchography by two radiologists independently in 27 patients (aged 20-67 years) undergoing investigation of chronic sputum production. Fifteen patients were found to have bronchiectasis by both investigations. Five were identified by computed tomography alone, including two in whom disease was revealed in segments underfilled at bronchography. The sensitivity of computed tomography compared with bronchography in the diagnosis of bronchiectasis at segmental level was 84% and the specificity 82%. The predictive value of computed tomography in the diagnosis of bronchiectasis was 38% overall, but increased to 75% when only those segmental bronchi moderately or severely dilated on the computed tomography scan were considered. There was no relation between the degree of bronchial wall thickening on the computed tomogram and the diagnosis of bronchiectasis by bronchography. Bronchography may be avoided in patients being considered for surgical resection of their bronchiectasis in whom computed tomography shows diffuse disease. (+info)
Computer-based route-definition system for peripheral bronchoscopy.
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