CTICasesBronchopulmonary Dysplasia with Mosaic Attenuation and Air Trapping
Imaging findings
A transplant patient with a history of mild dysplasia had a chest radiograph with essentially clear lungs but subtly irregular lung edges. CT showed extensive lobular mosaic attenuation, and expiratory imaging confirmed true air trapping with discrete puffed-up, hyperlucent lobules maintaining air on expiration, attributed to his history of prematurity, respiratory distress syndrome, and prolonged oxygen therapy as an infant (bronchopulmonary dysplasia).
Key takeaways
Bronchopulmonary dysplasia from premature birth and neonatal respiratory distress can produce a distinctive lobular mosaic attenuation and air-trapping pattern on CT in adulthood that mimics constrictive bronchiolitis or Swyer-James syndrome; this diagnosis should be considered in relatively young adults with unexplained lobular air trapping and moderate-to-severe obstruction on pulmonary function testing, especially with a history of prematurity.
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