CTICasesAlpha-1 Antitrypsin Deficiency with Bronchiectasis
Imaging findings
A chest radiograph shows a radial pattern of linear opacities in the lung bases. CT from the same era shows bronchiectasis predominantly in the lower lobes, with some mucus plugging or infection within these dilated airways. A comparison to a study from five years prior reveals an increase in cystic lesions, bronchial wall thickening, and airway dilation. The patient's only known abnormality is alpha-1 antitrypsin deficiency.
Key takeaways
While alpha-1 antitrypsin deficiency is commonly associated with basilar emphysema, it can also manifest as bronchiectasis, particularly in the lower lobes. This case highlights that alpha-1 antitrypsin deficiency should be considered as a cause of progressive bronchiectasis, even in the absence of typical emphysema.
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