Fact-sheet: Bronchectasis
Updated on 04/30/2026 at 10:29 AM
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Definition
Irreversible and permanent dilation of bronchial caliber.
Classification:
- Diffuse bronchiectasis (both lung fields) or localized (one lobe)
Etiologies:
Most often: acquired etiologies
Localized:
- foreign body
- tumors
- sequelae of localized pulmonary infections (tuberculosis).
- traction bronchiectasis (mechanical traction in a fibrotic area)
Diffuse:
- acute childhood bronchopneumopathies
- whooping cough
- ABPA
- bronchiolitis
- inhalation of toxic products
Congenital etiologies, developing in childhood:
- Cystic fibrosis (predominantly affecting the apices)
- Ciliary dyskinesia (predominantly affecting the middle lobe and lingula)
- Immune deficiencies
- Williams-Campbell syndrome, Mounier-Kuhn syndrome
Course:
- Localized forms:
uncomplicated course, rare and well-tolerated superinfections
- Diffuse forms:
frequent superinfections -> Chest physiotherapy!
Pneumonia, lung abcess
Bronchial hemorrhage
Chronic respiratory failure
Clinical features
- Chronic productive cough.
- Pulmonary infection.
- Hemoptysis.
Radiography
Low-sensitivity examination, showing only advanced and associated lesions.
- Bronchial syndrome: bronchial wall thickening ("tram-track sign"), associated with dilation of the bronchial lumen ("tubular lucency")
- Images of bronchi filled with secretions: V-shaped, Y-shaped, cluster-like densities, or nodular image (broncho-mucocele)
- Cystic images, sometimes with an air-fluid level
- Ventilation disorder: atelectasis
CT
Reference examination, without contrast injection.
MPR, MIP (mucoid impactions), and minIP (bronchi) reconstructions.
Bronchial dilation:
- Internal luminal diameter of the bronchus greater than that of the adjacent artery (signet-ring sign)
- Lack of tapering of this caliber.
- Bronchus visible in the periphery (2 cm in adults, 1 cm in children)
Associated lesions:
- Bronchial wall thickening.
- Mucoid impactions within the bronchiectases.
- Centrilobular micronodules in a tree-in-bud pattern related to superinfection.
- Air trapping.
Management
- Chest physiotherapy
- Antibiotic therapy if infection
Classification
3 main types of bronchiectasis according to the Reid classification:
- cylindrical: dilatations with regular and uniform margins
- varicose: irregular dilatations with a beaded appearance
- cystic: large rounded cavity communicating with the bronchial tree
Brody score:
(bronchiectasis, size, mucoid impaction, peribronchovascular thickening, parenchymal lesions)
