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Image of the month: Radiological findings in bronchiectasis

Uzma Kamdar, Dilip Oswal and Salim Meghjee
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DOI: https://doi.org/10.7861/clinmedicine.16-4-396
Clin Med August 2016
Uzma Kamdar
ADepartment of Respiratory Medicine, Pinderfields Hospital, Wakefield, UK
Roles: respiratory specialist registrar
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  • For correspondence: uzmakamdar@hotmail.com
Dilip Oswal
BDepartment of Radiology, Pinderfields Hospital, Wakefield, UK
Roles: consultant radiologist
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Salim Meghjee
CDepartment of Respiratory Medicine, Pinderfields Hospital, Wakefield, UK
Roles: consultant in respiratory medicine
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A 67-year-old patient with bronchiectasis, diagnosed at age 4, presented with worsening dyspnoea and hypoxia. Chest radiograph revealed finger in glove appearance in left lung and large cystic spaces at lung bases (Fig 1). A subsequent computed tomography scan ruled out pulmonary embolism; however, it showed the following interesting radiological features consistent with cystic-cylindrical bronchiectasis and bronchocoeles:

Fig 1.
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Fig 1.

Chest X-ray showing finger in glove sign (green arrow) and cystic spaces at lung bases (red arrow).

  1. Bunch of grapes sign1 – refers to dilated bronchi lying in close approximation giving the appearance of clusters of thin walled cysts (Figs 2 and 3). Similar appearances have also been described in hydatidiform mole and intraductal papillary mucinous neoplasm.

  2. Finger in glove sign2 – refers to dilated bronchi filled with mucus/mucoid impaction and are seen as opacities originating from hila directed peripherally (Figs 2 and 4).

  3. Bronchial arterial hypertrophy due to broncho-pulmonary shunting (Fig 5).

Fig 2.
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Fig 2.

Coronal section of CT thorax showing finger in glove (green arrow) and bunch of grapes sign (red arrow).

Fig 3.
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Fig 3.

CT section showing clusters of thin walled cystic spaces lying in close approximation ‘bunch of grape sign’.

Fig 4.
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Fig 4.

CT section showing dilated bronchi filled with mucous (red arrow).

Fig 5.
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Fig 5.

CT section showing bronchial artery hyperplasia (red arrow).

Competing interests

The authors declare no competing interests.

Acknowledgements

Written informed consent was obtained from the patient to publish the clinical details and images in this article.

  • © 2016 Royal College of Physicians

References

  1. ↵
    1. Naidich DP
    , Webb WR, Müller NL, Vlahos I, Krinsky GA. Computed tomography and magnetic resonance of the thorax, 4th edn. Philadelphia: Lippincott Williams & Wilkins, 2007.
  2. ↵
    1. Nguyen ET
    . The gloved finger sign. Radiology 2003;227:453–4.
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Image of the month: Radiological findings in bronchiectasis
Uzma Kamdar, Dilip Oswal, Salim Meghjee
Clinical Medicine Aug 2016, 16 (4) 396-397; DOI: 10.7861/clinmedicine.16-4-396

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Image of the month: Radiological findings in bronchiectasis
Uzma Kamdar, Dilip Oswal, Salim Meghjee
Clinical Medicine Aug 2016, 16 (4) 396-397; DOI: 10.7861/clinmedicine.16-4-396
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