The Trachea and Bronchi

  • Mary M. Salvatore
  • Ronaldo Collo Go
  • Monica A. Pernia M.


Evaluation of the trachea and bronchi should be performed on lung window settings. This chapter looks at the normal anatomy of the trachea and bronchi and common anatomical variants. Next we review diseases of the trachea which can be focal such as cancer or diffuse, involving a large segment of the trachea such as amyloidosis. Bronchiectasis is irreversible dilation of the bronchi which become larger than their accompanying artery. Bronchiectasis can be focal or diffuse. Focal bronchiectasis occurs with bronchial atresia. Diffuse bronchiectasis can be central or peripheral. Central bronchiectasis is seen with allergic bronchopulmonary aspergillosis (ABPA). Distal bronchiectasis occurs in patients with infection. The distribution of the bronchiectasis helps to narrow the differential diagnosis.


Mounier-Kuhn Allergic bronchopulmonary aspergillosis Bronchial atresia Williams-Campbell Sarcoidosis 


  1. 1.
    Minnich DJ, Mathisen DJ. Anatomy of the trachea, carina, and bronchi. ThoracSurgClin. 2007;17(4):571–85.Google Scholar
  2. 2.
    Doolittle AM, Mair EA. Tracheal bronchus: classification, endoscopic analysis, and airway management. Otolaryngol Head Neck Surg. 2002;126(3):240–3.CrossRefPubMedGoogle Scholar
  3. 3.
    Berrocal T, Madrid C, Novo S, Gutiérrez J, Arjonilla A, Gómez-León N. Congenital anomalies of the tracheobronchial tree, lung, and mediastinum: embryology, radiology, and pathology. Radiographics. 2004;24(1):e17.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    McGuinness G, Naidich DP, Garay SM, Davis AL, Boyd AD, Mizrachi HH. Accessory cardiac bronchus: CT features and clinical significance. Radiology. 1993;189(2):563.CrossRefPubMedGoogle Scholar
  5. 5.
    Ghosh S, Yarmish G, Godelman A, et al. Anomalies of visceroatrial situs. AJR Am J Roentgenol. 2009;193(4):1107–17.CrossRefPubMedGoogle Scholar
  6. 6.
    Ivemark BI. Implications of agenesis of the spleen on the pathogenesis of conotruncus anomalies in childhood; an analysis of the heart malformations in the splenic agenesis syndrome, with fourteen new cases. ActaPaediatr. 1955;44(Suppl 104):7–110.Google Scholar
  7. 7.
    Winer-Muram HT, Tonkin ILD, Gold RE. Polysplenia syndrome in the asymptomatic adult: computed tomography evaluation. J Thorac Imaging. 1991;6:69–71.CrossRefPubMedGoogle Scholar
  8. 8.
    Laroia AT, Thompson BH, Laroia ST, van Beek EJ. Modern imaging of the trachea-bronchial tree. World J Radiol. 2010;2(7):237–48.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Carden KA, Boiselle PM, Waltz DA, Ernst A. Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest. 2005;127:984–1005.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Ridge CA, O’Donnell CR, Lee EY, Majid A, Boiselle PM. Tracheobronchomalacia: current concepts and controversies. J Thorac Imaging. 2011;26(4):278–89.CrossRefPubMedGoogle Scholar
  11. 11.
    Daum TE, Specks U, Colby TV, Edell ES, Brutinel MW, Prakash UB, DeRemee RA. Tracheobronchial involvement in Wegener’s granulomatosis. Am J Respir Crit Care Med. 1995;151(2 Pt 1):522–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Soares MT, Sousa C, Garanito L, Freire F. Extensive upper respiratory tract sarcoidosis. BMJ Case Rep. 2016.
  13. 13.
    O’Regan A, Fenlon HM, Beamis JF Jr, Steele MP, Skinner M, Berk JL. Tracheobronchial amyloidosis. The Boston University experience from 1984 to 1999. Medicine (Baltimore). 2000;79(2):69–79.CrossRefGoogle Scholar
  14. 14.
    Lu DG, Ji XQ, Zhao Q, Zhang CQ, Li ZF. Tracheobronchial nodules and pulmonary infiltrates in a patient with Crohn’s disease. World J Gastroenterol. 2012;18(39):5653–7.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Schina M, Karsaliakos P, Apostolou T, Mousoulis G. Relapsing polychondritis as a secondary phenomenon of primary systemic vasculitis. ClinNephrol. 2008;70(5):446–9.Google Scholar
  16. 16.
    Wang N, Long F, Jiang S. Tracheobronchopathia osteochondroplastica: two cases reports and review of literature. Medicine. 2016;95(19):e3396.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Urdaneta AI, Yu JB, Wilson LD. Population based cancer registry analysis of primary tracheal carcinoma. Am J Clin Oncol. 2011;34:32–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Heidinger BH, Occhipinti M, Eisenberg RL, Bankier AA. Imaging of large airways disorders. AJR Am J Roentgenol. 2015;205(1):41–56.CrossRefPubMedGoogle Scholar
  19. 19.
    Maselli DJ, Amalakuhan B, Keyt H, Diaz AA. Suspecting non-cystic fibrosis bronchiectasis: what the busy primary care clinician needs to know. Int J ClinPract. 2017;71(2). Scholar
  20. 20.
    Reid LM. Reduction in bronchial subdivision in bronchiectasis. Thorax. 1950;5(3):233–47.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Ashour M. Hemodynamic alterations in bronchiectasis: a base for a new subclassification of the disease. J Thorac Cardiovasc Surg. 1996;112:328–34.CrossRefPubMedGoogle Scholar
  22. 22.
    Traibi A, Seguin-Givelet A, Grigoroiu M, Brian E, Gossot D. Congenital bronchial atresia in adults: thoracoscopic resection. J Visc Surg. 2017;30(3):174.CrossRefGoogle Scholar
  23. 23.
    Dakkak M, Siddiqi F, Cury JD. Broncholithiasis presenting as bronchiectasis and recurrent pneumonias. BMJ Case Rep. 2015;23:2015.Google Scholar
  24. 24.
    Meisinger QC, Klein JS, Butnor KJ, Gentchos G, Leavitt BJ. CT features of peripheral pulmonary carcinoid tumors. AJR Am J Roentgenol. 2011;197(5):1073–80.CrossRefPubMedGoogle Scholar
  25. 25.
    Agarwal R. Allergic bronchopulmonary aspergillosis: lessons for the busy radiologist. World J Radiol. 2011;3(7):178–81.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Noriega Aldave AP, William Saliski D. The clinical manifestations, diagnosis, and management of Williams-Campbell Syndrome. N Am J Med Sci. 2014;6(9):429–32.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Abehsera M, Valeyre D, Grenier P, Jaillet H, Battesti JP, Brauner MW. Sarcoidosis with pulmonary fibrosis: CT patterns and correlation with pulmonary function. AJR Am J Roentgenol. 2000;174(6):1751–7.CrossRefPubMedGoogle Scholar
  28. 28.
    Jennings FLAA. Development of radiation pneumonitis: time and dose factor. Arch Pathol. 1962;74:351–60.Google Scholar
  29. 29.
    Benveniste MFK, Welsh J, Godoy MCB, Betancourt SL, Mawlawi OR, Munden RF. New era of radiotherapy: an update in radiation-induced lung disease. Clin Radiol. 2013;68(6):e275–90.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Reich JM, Johnson RE. Mycobacterium avium complex pulmonary disease presenting as an isolated lingular or middle lobe pattern. The lady Windermere syndrome. Chest. 1992;101(6):1605–9.CrossRefPubMedGoogle Scholar
  31. 31.
    Skeik N, Fl J. Kartagener Syndrome. International Journal of General Medicine. 2011;4:41–3.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Vignes S, Baran R. Yellow nail syndrome: a review. Orphanet J Rare Dis. 2017;12:42.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    De longh R, Ing A, Rutland J. Mucociliary function, ciliary ultrastructure, and ciliary orientation in Young’s syndrome. Thorax. 1992;47(43):184–7.Google Scholar
  34. 34.
    Perandini S, Faccioli N, Zaccarella A, Re TJ, Mucelli RP. The diagnostic contribution of CT volumetric rendering techniques in routine practice. Indian J Radiol Imaging. 2010;20(2):92–7.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mary M. Salvatore
    • 1
  • Ronaldo Collo Go
    • 2
  • Monica A. Pernia M.
    • 3
  1. 1.RadiologyIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Division of Pulmonary, Critical Care, and Sleep MedicineCrystal Run Health CareMiddletownUSA
  3. 3.Internal MedicineNew York Medical College - Metropolitan Hospital ProgramNew YorkUSA

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