Lung Bronchiectasis pathology
Bronchiectasis is the permanent abnormal dilatation of the bronchi caused by destruction of the bronchial wall due to chronic infection and inflammation.
CLINICAL FEATURES
1-Persistent productive cough ( chronic cough )
Cough continue for long time with sputum .
The patient experience cough because in infection of bronchi more mucus secreted and our body tried to remove from our body by coughing.
2-Large amount of thick , purulent,foul smelling sputum is produced.
3-Blood may appear in sputum due to damage of bronchial blood vessels ( hemoptysis)
4-Dyspnea-Bronchiectasis occur due to infection so the bronchi become dilated and filled with mucus and blood.
This mucus and blood causes Blockage of airway and reduce oxygen entry from outside to the lungs.so the breathing becomes difficult.
5-Fever during infection
Due to bronchiectasis or infection in bronchi develop fever in patient.
6-Chest pain- Repeated infection cause chest pain happened in bronchiectasis.
COMPLICATION
1-Hemoptysis-
In bronchiectasis, repeated infection and inflammation damage the bronchial wall.
Small blood vessels present in the bronchi may rupture.
Blood mixes with mucus and comes out during coughing.
2- Amyloidosis-
When bronchiectasis continues for many years, infection and inflammation also continue for a long time.
Because of this, the body produces an abnormal protein called amyloid.
This protein slowly collects in organs like the kidney, liver, and spleen.
The collected amyloid can damage these organs.
This condition is called amyloidosis.
3-Septicemia
In bronchiectasis, repeated bacterial infection occurs in the bronchi.
Sometimes bacteria spread from the lungs into the bloodstream.
When bacteria enter and multiply in blood, it causes a serious infection called septicemia (blood infection).
4-Septic shock
In severe bronchiectasis, repeated lung infection may spread into the blood and cause septicemia.
The infection then produces a strong body reaction, causing blood pressure to fall suddenly.
Due to low blood pressure, organs do not get enough oxygen and blood supply.
This serious condition is called septic shock.
5-Lung abscess
In bronchiectasis, mucus collects inside the dilated bronchi.
Bacteria grow in this mucus and cause severe infection.
Sometimes the infection spreads into the lung tissue and destroys it.
This leads to formation of a cavity filled with pus in the lung.
This pus-filled cavity is called a lung abscess.
6-Pneumonia
In bronchiectasis, bronchi become dilated and filled with mucus.
Bacteria grow in this mucus anhd cause repeated infection.
The infection may spread to the alveoli (air sacs) of the lungs.
This causes inflammation and consolidation of lung tissue, leading to pneumonia.
7-Pleurisy
In bronchiectasis, repeated infection and inflammation occur in the lungs.
Sometimes the infection spreads to the pleura (covering of lungs).
This causes inflammation of the pleura, leading to chest pain during breathing.
This condition is called pleurisy.
8-Empyema
In bronchiectasis, repeated bacterial infection occurs in the bronchi.
Sometimes the infection spreads from the lungs to the pleural cavity (space around the lungs).
Pus then collects in the pleural cavity.
This collection of pus is called empyema.
9-Fibrosis
In bronchiectasis, repeated infection and inflammation damage the lung tissue.
During healing, scar tissue forms in the lungs.
Repeated damage and healing over many years increase scar formation.
This leads to fibrosis.
10-Cor pulmonale
In bronchiectasis, repeated infection and lung damage reduce oxygen in the blood.
Low oxygen causes narrowing of pulmonary blood vessels.
This increases pressure in pulmonary circulation (pulmonary hypertension).
The right side of the heart has to work harder to pump blood.
Over time, the right side of the heart enlarges and fails.
This condition is called cor pulmonale.
GROSS APPEARANCE
1-Lungs becomes hard and scarred
2-Many small holes and cyst are formed and look like honey comb .
3-The lungs become smaller and damaged
4-The cyst may contain pus
5-Mostly seen near the outer surface of the lungs
HISTOLOGY OF BRONCHIECTASIS
1-Bronchial wall shows chronic inflammation.
2-Many inflammatory cells like neutrophils are present.
3-Destruction of bronchial wall occurs.
4-Elastic tissue and smooth muscle are damaged.
5-Bronchi become dilated permanently.
6-Ulceration of bronchial lining may be seen.
7- Surrounding lung tissue shows fibrosis (scar formation).
8-Sometimes mucus and pus are present inside bronchi.
PATHOGENESIS OF BRONCHIECTASIS
Airway obstruction / Infection
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Accumulation of mucus in bronchi
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Bacterial growth and repeated infection
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Chronic inflammation of bronchial wall
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Destruction of smooth muscle and elastic tissue
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Weakening of bronchial wall
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Permanent dilatation of bronchi
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Collection of pus and mucus
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Bronchiectasis develops.
