Bronchiectasis: Retrospective Analysis of Clinical and Pathological Findings in a Tertiary-Care Hospital.

Ayşe Nur Akatlı ,Emine Şamdancı ,Hakkı Ulutaş ,Muhammet Reha Çelik

doi:10.1155/2022/8773204

Ayşe Nur Akatlı , Emine Şamdancı + Show 2 more

Open Access

https://doi.org/10.1155/2022/8773204

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Abstract

Background Bronchiectasis is still a challenging chronic lung disease in developing countries. Patients with bronchiectasis can also have pulmonary hypertension. There are sparse data on the prevalence of pulmonary hypertension in patients with bronchiectasis. Materials and methods. Archived H&E-stained slides of 141 patients histopathologically diagnosed with bronchiectasis were reevaluated. Cases were categorized into 4 subgroups based on histology: tubular, varicose, follicular, and cystic. In addition, concomitant histopathological changes were also reevaluated. For patients with available CT sections, main, right, and left pulmonary artery (PA) diameters and PA/aorta ratio were measured with regard to pulmonary hypertension. Results Of the cases, 70% (n = 89) were female and 30% (n = 52) were male, with a mean age of 36.58 in females and 33.84 in males. Histopathologically, 43% (n = 68) of the cases showed follicular, 37% (n = 59) showed varicose, 35% (n = 56) showed tubular, and 28% (n = 45) showed cystic bronchiectasis morphology. All cases showed chronic inflammation, fibrosis, muscle destruction, and cartilage destruction. Aspergillus were present in 11% of the cases showing cystic morphology. Approximately 17% of the cases (n = 24) were found to have neuroendocrine cell proliferations. In cases with medial hypertrophy, a statistically significant increase in the left pulmonary artery diameter was radiologically determined. Conclusions Medial hypertrophy was found to be significant with regard to indicating a radiological increase in left pulmonary artery diameter. Vascular changes observed in bronchiectasis cases and the presence of neuroendocrine cell proliferations should be specified in pathology reports, and aspergilloma should be carefully investigated in cases with predominant cystic morphology.

Highlights

Bronchiectasis is still a challenging chronic lung disease in developing countries
We found in the present study that the risk of folliculartype bronchiectasis decreases as age increases and that follicular-type bronchiectasis is prevalent in children and young adults. e varicose, cystic, and tubular bronchiectasis subtypes were not found to have a significant relationship with age
One-third of our cases were histopathologically determined to have medial hypertrophy (MH); this condition can be present in smokers without pulmonary arterial hypertension (PH), we think that it should be considered significant due to indicating increased left pulmonary artery (PA) diameter

Summary

Introduction

Bronchiectasis is still a challenging chronic lung disease in developing countries. It is characterised by permanent dilation and abnormal widening of the bronchi that usually occurs in the context of airway inflammation [1].e clinical spectrum of the disease is broad. 43% (n 68) were classified as follicular, 37% (n 59) varicose, 35% (n 56) tubular, and 28% (n 45) cystic bronchiectasis. According to the results of single binary LRA, variables that were significant (p < 0.05) risk factors influencing the cystic-type bronchiectasis were FB and interstitial pneumonia (Table 2), and risk factors for the varicose-type were FB, bronchopneumonia, medial hypertrophy (MH), and emphysema (Table 3).

Results

Conclusion