Imaging
Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology.
The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend. Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend.
Medical Image of the Week: Accessory Cardiac Bronchus
Figure 1. Axial (Panel A) and Coronal (Panel B) CT Chest demonstrate an accessory cardiac bronchus that can be seen in the axial and coronal views (arrows) arising from the bronchus intermedius.
A 77-year-old man with a 120 pack-year smoking history was found to have incidental rudimentary bronchus arising from the medial wall of the bronchus intermedius on thoracic CT obtained for lung nodule evaluation.
A congenital tracheobronchial anomaly called a cardiac bronchus was first described in 1946 by Brock and is thought to develop in the 6th week of gestation. The incidence of a cardiac bronchus is reported as 0.07 – 0.5% and is most commonly seen arising directly opposite the right upper lobe orifice. The average diameter is 8.7 mm and the average length is 12mm advancing in a caudal direction towards the pericardium. Cardiac bronchi are lined by normal bronchial mucosa and have cartilage, which distinguish them from acquired diverticula. Most end abruptly but some do develop small bronchioles and bronchiolar parenchymal tissue. Accessory cardiac bronchi are usually asymptomatic and discovered incidentally as in this case, but can be associated with cough, hemoptysis, and recurrent infections. Pulmonologists should be aware of this congenital accessory bronchus in order to properly evaluate patients during diagnostic bronchoscopy.
Bhupinder Natt MD, Veronica Arteaga MD, Janet Campion MD
University of Arizona Medical Center, Tucson AZ.
Reference
Desir A, Ghaye B. Congenital anomalities of intrathoracic airways. Radiologic Clinics of North America. 2009; 47(2); 203-225. [CrossRef] [PubMed]
Reference as: Natt B, Arteaga V, Campion J. Medical image of the week: accessory cardiac bronchus. Southwest J Pulm Crit Care. 2013:7(3):193. doi: http://dx.doi.org/10.13175/swjpcc126-13 PDF