CTICasesAspiration bronchiolitis from esophageal mucositis
Imaging findings
Chest CT in a neutropenic stem cell transplant patient shows bilateral, symmetrical, tree-in-bud opacities, peribronchial thickening, and minor interstitial edema in the lower lung zones, associated with wall thickening and debris in the lower esophagus.
Key takeaways
Chemotherapy-induced esophageal mucositis can cause severe pain and dysphagia, leading to silent aspiration. Radiographically, this presents as bilateral, dependent tree-in-bud opacities and bronchial thickening (aspiration bronchiolitis) rather than primary pulmonary infection.
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