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Focal Abnormalities of the Trachea and Main Bronchi

Edith M. Marom1, Philip C. Goodman and H. Page McAdams

1 All authors: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.



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  		Fig. 1A. —Histoplasmosis in 39-year-old man with recurrent pneumonia. CT scan (5-mm collimation) shows smooth left main bronchus thickening and stenosis (arrow) and adjacent coarse calcifications. a = ascending aorta.

 


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  		Fig. 1B. —Histoplasmosis in 39-year-old man with recurrent pneumonia. Coronal reconstruction better reveals focal narrowing of left main bronchus (curved arrow). Calcified lymph nodes can be seen surrounding stricture, in subcarinal region, and in both hila (straight arrows). L = left main bronchus, R = right main bronchus, S = calcified subcarinal lymph nodes.

 


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  		Fig. 2A. —Foreign-body aspiration in 55-year-old man. CT scan (3-mm collimation) shows well-circumscribed mass in bronchus intermedius (arrow).

 


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  		Fig. 2B. —Foreign-body aspiration in 55-year-old man. Internal volumetric rendering of CT scan (3-mm collimation) reveals well-circumscribed soft-tissue nodule (arrows) along anterior (nondependent) surface of bronchus intermedius.

 


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  		Fig. 2C. —Foreign-body aspiration in 55-year-old man. Photograph obtained during bronchoscopy shows that "mass" (arrows) is aspirated pea.

 


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  		Fig. 3. —Stenosis at left bronchial anastomosis in 27-year-old woman 9 months after bilateral lung transplantation for cystic fibrosis. Coronal oblique shaded-surface display image from CT scan (3-mm collimation) shows focal stenosis at left bronchial anastomosis (arrows).

 


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  		Fig. 4A. —Adherent mucus in 66-year-old man being evaluated for pulmonary embolism. CT scan (2.5-mm collimation) shows 3-mm soft-tissue nodule along the left lateral tracheal wall (arrow).

 


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  		Fig. 4B. —Adherent mucus in 66-year-old man being evaluated for pulmonary embolism. Repeated CT scan that was obtained after patient vigorously coughed shows that nodule is no longer present and, thus, likely represented adherent mucus.

 


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  		Fig. 5. —Tracheal stenosis caused by prolonged intubation in 57-year-old woman. CT scan (10-mm collimation) shows concentric soft-tissue thickening endotracheally (open arrow) and in surrounding tissues (solid arrows). Multiple biopsies and 5-year follow-up proved this finding to be inflammatory changes in region of endotracheal balloon cuff.

 


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  		Fig. 6. —Tooth aspiration in 27-year-old man with multiple mandibular fractures after motor vehicle crash. Anteroposterior chest radiograph after line placement reveals tooth extending into left upper lobe bronchus (arrow).

 


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  		Fig. 7A. —Left main bronchus stenosis from tuberculosis in 32-year-old woman. (Courtesy of Choi YW, Seoul, Korea) CT scan (3-mm collimation) shows normal caliber of right main bronchus and marked concentric narrowing of left main bronchus (arrow). R = right main bronchus, e = esophagus.

 


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  		Fig. 7B. —Left main bronchus stenosis from tuberculosis in 32-year-old woman. (Courtesy of Choi YW, Seoul, Korea) Coronal reconstruction shows left main bronchus stenosis involves short focal segment (white arrow). Incidental note is made of mediastinal lymph node calcification (black arrow). r = right main bronchus.

 


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  		Fig. 8. —Tracheal papilloma in 49-year-old woman with known laryngeal papillomas. CT scan (10-mm collimation) reveals 6-mm intratracheal nodule, consistent with tracheal papilloma (arrow).

 


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  		Fig. 9. —Endobronchial hamartoma in 42-year-old man with persistent right middle lobe atelectasis on chest radiographs (not shown). CT scan (5-mm collimation) shows mass (black arrows) of mixed fat (white arrow) and soft-tissue attenuation involving right middle lobe bronchus, resulting in right middle lobe atelectasis. Lobectomy confirmed endobronchial hamartoma.

 


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  		Fig. 10. —Squamous cell carcinoma of trachea in 73-year-old man with hemoptysis. CT scan (10-mm collimation) shows mass centered around anterior and left lateral tracheal wall (curved arrows); mass is disrupting calcified tracheal ring (straight arrow).

 


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  		Fig. 11. —Adenoid cystic carcinoma of trachea in 39-year-old man with increasing shortness of breath. CT scan (7-mm collimation) shows polypoid mass (arrows) protruding into trachea, involving its posterolateral wall.

 


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  		Fig. 12. —Squamous cell carcinoma of left upper lobe bronchus in 71-year-old man with hemoptysis. CT scan (10-mm collimation) shows circumferential narrowing of left upper lobe bronchus (arrows). Endobronchial biopsy revealed squamous cell carcinoma. e = effusion.

 


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  		Fig. 13. —Bronchial carcinoid tumor in 27-year-old woman with expiratory wheezing. CT scan (7-mm collimation) reveals left upper lobe atelectasis with compensatory hyperaeration of left lower lobe. Note well-circumscribed mass in left main bronchus (arrow). Biopsy showed typical carcinoid tumor. a = left upper lobe atelectasis.

 


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  		Fig. 14. —Endotracheal metastasis from renal cell carcinoma in 75-year-old man with stridor. Cone-down view of posteroanterior chest radiograph reveals well-marginated mass (arrows) in extrathoracic trachea. Biopsy results were consistent with renal cell carcinoma metastasis.

 


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  		Fig. 15. —Endobronchial metastasis from colon carcinoma in 56-year-old man with hemoptysis. CT scan (8-mm collimation) reveals 8-mm soft-tissue mass in right main bronchus (arrow). Endobronchial biopsy results were consistent with colon carcinoma metastasis.

 

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