Cardiogenic bronchus

Clinical History

A 40-year-old male patient underwent a CT examination of the chest to check a previous bronchopneumonia after antibiotic therapy. Chest examination was negative as there were no respiratory symptoms such as cough and fever.

Imaging Findings

CT examination of the chest was performed without injection of iodinated contrast medium. It showed a small accessory bronchus originating from the medial wall of the middle right bronchus and extending downward and medially to the mediastinum (figure 1).
Axial scans and MPR-MinIP reconstructions showed also a small portion of poorly ventilated pulmonary parenchyma around the bronchus, but no bronchopneumonia foci were found (figure 2).

Discussion

Cardiogenic accessory bronchus is a rare anatomical variant with an incidence of 0.1% in the general population.
It consists of a developmental aberration of bronchial branching occurring between the 4th and 6th weeks of embryonic life. It is lined by endobronchial mucosa, presenting cartilaginous rings within its walls [1, 2].
It originates from the medial wall of the right middle or lower bronchus and can extend caudally 1-5 cm towards the pericardium or it can be a short dead-end abutment without presenting alveolar ventilated tissue [3]. The associated alveolar tissue can be more or less ventilated so even if in most cases this anatomical variant is asymptomatic, sometimes it can be associated with chronic infections and haemoptysis.

Differential Diagnosis List

Final Diagnosis

Cardiogenic bronchus

URL:	https://www.eurorad.org/case/9846
DOI:	10.1594/EURORAD/CASE.9846
ISSN:	1563-4086