What are the broad aetiologies of bronchiectasis?
Congenital, post-infectious, bronchial obstruction, fibrosis, connective tissue disorders. A useful mnemonic is "Captain Kangaroo has Mounier Kuhn."
What are the three morphological types of bronchiectasis?
1. Cylindrical (most common) 2. Varicose (least common, can be seen in traction bronchiectasis secondary to fibrosis) 3. Cystic (often has air fluid levels as in this case)
What are some specific causes of middle lobe bronchiectasis?
Non-tuberculous mycoplasma (NTM) or mycoplasma avium cellulare (MAC) infection in adults and middle lobe syndrome in children.
- bilateral cystic bronchiectasis particularly the middle lobe
- air-fluid levels in the cystic spaces due to chronic infection
- architectural distortion and pleuroparenchymal scarring secondary to fibrosis
- volume loss in the right hemithorax
- main pulmonary artery is enlarged
- heart size is enlarged