Bronchocele (bronchial retention cyst): from structure to diagnosis

Abstract

SummaryIntroduction. Bronchocele is a relatively frequent inci-dental finding on computed tomography and is a dilated bronchus filled with mucous content due to continued se-cretion of the mucous membrane and proximal airway ob-struction, which often manifests itself as tubular branched structures associated with the bronchial tree («Finger in glove» sign). Purpose: to present “from simple to complex” diagnostic algorithm for detecting changes in the type of bronchocele on computed tomography. Results. The dif-ferential diagnosis of the causes of bronchocele is wide and includes both congenital and acquired pathologies, which can be divided into obstructive and non-obstructive. Also, etiology-wise, they can be divided into the following groups: congenital infectious pathology, and obstruction of the bronchus by masses or foreign body. Computed tomography is the preferred method for diagnosing bron-chocele; in some cases, CT is performed in combination with contrast enhancement for differential diagnosis with arteriovenous malformation or atypical manifestation of lung metastases. In case of a locally located bronchocele, obstructive genesis by masses or foreign body should always be excluded, which requires the use of broncho-scopic examination methods. The most difficult option for differential diagnosis is bronchocele caused by infectious agents, due to the non-specificity of the radiation pattern. To make a correct diagnosis, it is necessary to verify and identify the pathogen. Conclusion. The paper presents a diagnostic algorithm that allows to optimally diagnoseis the “bronchocele” type changes.