Date: 26 November 2013
D Sinusitis radiology with fluid level
Copyright:
Fungal Infection Trust
Notes:
Bronchography (A & B)is an old technique for visualising the bronchial tree, by introducing radio-opaque dye into the airways and then taking a chest Xray. It was the first means used to diagnose bronchiectasis, seen in these examples below. An historical description of the technique from 1922 can be seen here
Nowadays CT scanning of the chest is used for this purpose with 3D reconstruction in some cases.
White cell scan (C) This pair of white cell scans from different people show almost no white cells in the lungs on the left, as in a healthy person (the spleen is the ‘hottest area). The scan on the right shows grossly increased update, especially in the left lung (seen on the right). This is the typical feature of severe bronchiectasis with large amounts of neutrophils and other phagocytes present.
Sinusitis Plain X-ray (D) of the face showing the maxillary sinuses. The right maxillary sinus is complete fluid filled and the left side (seen on the right) has a fluid level. These features may be seen with severe acute bacterial sinusitis, but also other causes of sinusitis, including allergic rhinosinusitis.
Images library
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Legend
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Bronchoscopic manifestations of Aspergillus tracheobronchitis. (a) Type I. Inflammatory infiltration, mucosa hyperaemia and plaques of pseudomembrane formation in the lumen without obvious airway occlusion. (b) Type II. Deep ulceration of the bronchial wall. (c) Type III. Significant airway occlusion by thick mucous plugs full of Aspergillus without definite deeper tissue invasion. (d) Type IV. Extensive tissue necrosis and pseudomembrane formation in the lumen with airway structures and severe airway occlusion (Wu 2010).
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High resolution CT showing centrilobular nodular opacities and branching linear opacities (tree-in-bud appearance) (Al-Alawi 2007).
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Chest X-ray showing poorly defined bilateral nodular opacities (Al-Alawi 2007).
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Gross pathologic specimen from autopsy shows the bronchial lumen covered by multiple whitish endobronchial nodules (arrows) (Franquet 2002).
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Invasive tracheobronchitis showing numerous nodules seen during bronchoscopy (Ronan D’Driscoll).
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Pseudomembranous seen overlying the bronchial mucosa (Tasci 2006).
