CTICasesCongenital Bronchial Atresia
Imaging findings
Chest radiograph shows a density in the right apex with surrounding rarefaction. CT demonstrates a mucocele in the right upper lobe apical region, appearing as a branching low-attenuation mucus plug surrounded by hyperinflated lung secondary to collateral ventilation. The coronal view dramatically shows the extent of mucus impaction and surrounding hyperlucency. No evidence of extrinsic central airway compression is seen, and the finding is consistent with isolated bronchial atresia. A second case in the same session shows right upper lobe bronchial atresia with similar CT findings including a mucocele and hyperinflation of the entire apical segment.
Key takeaways
Congenital bronchial atresia is a developmental anomaly in which a lobar, segmental, or subsegmental bronchus is focally interrupted, leading to accumulation of mucus distal to the atresia (mucocele) and air trapping from collateral ventilation. The CT triad of a branching or tubular central mucus plug, surrounding hyperlucent lung, and lack of central airway compression is characteristic. The left upper lobe is most commonly affected but right-sided and lower lobe cases occur. It is an incidental finding in otherwise asymptomatic patients and generally does not require intervention.
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