Fig. 1 Chest X-ray on admission, with infiltrative shadow in the right upper lung field. Fig. 2 Chest CT scan shows an infiltrative shadow, multiple b

congenital bronchial atresia, obstructive pneumonia

Fig. 1 Chest X-ray on admission, with infiltrative shadow in the right upper lung field. Fig. 2 Chest CT scan shows an infiltrative shadow, multiple bullae and dilated bronchi in the right S2.

Fig. 3 Complete obstruction of the orifice of right B2 covered with normal mucosa seen on bronchoscopy. Fig. 4 Bronchograms show no filling of the right B2 (a,b).

Fig. 5 Chest X-ray two years before admission showed hyperlucency in the upper and middle lung fields. The hair line is shifted downword. Fig. 6 The resected lung contains dilated bronchi containing mucoid material in the hilar region of S2, and emphysema associated with obstructive pneumonia. The proximal part of the bronchus has a blind ending.

Fig. 7 Photomicrograph of a cystically distended bronchus. The wall of the bronchus contains cartilage, bronchial glands and ciliated epithelium. (H. E. ~ 5).

1) Ramsay BH : Mucocele of the lung due to congenital obstruction of a segmental bronchus, a case report, relationship to congenital cystic disease of the lung and to congenital bronchiectasis. Dis Chest 24 : 96-103, 1953. 2) Culiner MM and Grimes OF : Localized emphysema in association with broncial cysts or mucoceles. J Thorac Cardiovasc Surg 41 : 306-313, 1961. 3) Jederlinic PJ, Sicilian LS, Baigelman W, et al : Congenital bronchial atresia, A report of 4 cases and a review of the literature. Medicine 65 : 73-83, 1986. 6) Bucher U and Reid L: Development of the intrasegmental bronchial tree: The pattern of branching and development of cartilage at various stages of intra-uterine life. Thorax 16 : 207-218, 1961. 7) McAlister WH, Wright JR and Crane JP : Main-stem bronchial atresia : intrauterine sonographic diagnosis. Am J Roentgenol 148: 364-366, 1987. 8) Meng RL, Jensik RJ, Faber LP, et al : Bronchial atresia. Ann Thorac Surg 25 : 184-192, 1978. 9) Williams AJ and Schuster SR : Bronchial atresia associated with a bronchogenic cyst. Chest 87 : 396-398. 1985.

Congenital bronchial atresia a case report Mitsuo Nakayama, Takatsugu Satoh, Chikao Torikata* Department of Surgery, Kyosai Tachikawa Hospital, Tachikawa, Tokyo, Japan *Department of Pathology, Keio University School of Medicine, Tokyo, Japan A 26-year-old male consulted a doctor with complaints of cough, fever and right chest pain. Medication ameliorated the symptoms for some time, but he was later admitted to our hospital with recurrent right chest pain. Chest X-ray showed an infiltrative shadow in the right upper lung field. Chest CT scan also demonstrated an infiltrative shadow in which multiple bullae and dilated bronchi were observed in the right S2. Bronchoscopic and bronchographic examinations revealed a B2 defect. He was therefore diagnosed as having congenital bronchial atresia associated with obstructive pneumonia. Since the infiltrative shadow did not disappear in spite of antibiotic therapy, right upper lobectomy was performed. The resected lung had dilated bronchi containing mucoid material in the hilar region of S2, and emphysema associated with obstructive pneumonia. The proximal part of the bronchus had a blind ending.