CTICasesAspiration Bronchiolitis
Imaging findings
Serial chest CT scans in a patient with a history of gastric bypass surgery show recurrent, asymmetric ground-glass and consolidative centrilobular nodules predominantly involving the mid-to-lower lung zones. The esophagus is chronically dilated and fluid-filled. Surgical lung biopsy of the left lower lobe confirms bronchocentric granulomas containing foreign vegetable material.
Key takeaways
Aspiration bronchiolitis is a chronic inflammatory response caused by repeated inhalation of foreign particulate matter (such as food or gastric secretions). It classically presents with asymmetric, central-to-lower lobe predominant centrilobular tree-in-bud or ground-glass nodules. Gastric bypass or esophageal motility disorders are strong predisposing factors, and histological identification of foreign material is diagnostic.
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