Bronchopulmonary Dysplasia

  • Etiology:
    — Lung disease caused by preterm birth and lung development in extrauterine environment
    — Definition is premature infants with respiratory distress syndrome who are chronically ventilated for more than 30 days
  • Imaging:
    — Hyperexpanded lungs due to emphysematous blebs with interstitial scarring
    — CXR findings normalize over very long-term but CT findings never normalize
  • DDX:
  • Complications: Pulmonary insufficiency
  • Treatment:
  • Clinical:
    — Is the more severe phenotype of a continuum of lung disease caused by extrauterine development due to preterm birth
    — Has more severe clinical course than chronic lung disease

Radiology Cases of Bronchopulmonary Dysplasia

CXR of bronchopulmonary dysplasia
CXR AP+lateral shows bilaterally increased interstitial lung markings and increased lung volumes along with emphysematous blebs in the left upper, left lower and right lower lobes.
CXR and CT of bronchopulmonary dysplasia
CXR (above) shows hyperexpansion and fine interstitial infiltrates. Axial CT without contrast of the chest (below) shows diffuse alveolar and interstitial lung disease bilaterally that is more prominent in the perihilar regions.
Chest CT of bronchopulmonary dysplasia
Coronal CT without contrast of the lungs shows bilaterally increased interstitial lung markings and increased lung volumes along with an emphysematous bleb in the left lower lobe.

Radiology Cases of Bronchopulmonary Dysplasia With Nasogastric Tube in the Right Mainstem Bronchus

CXR of nasogastric tube in the right mainstem bronchus in a patient with bronchopulmonary dysplasia
CXR AP shows the tip of the nasogastric tube to project over the right lower lobe. The lungs are hyperexpanded bilaterally with emphysematous blebs and interstitial scarring

Radiology Cases of Wilson Mikity syndrome

CXR of Wilson Mikity syndrome
CXR AP at 1 day of life (above) shows bilateral symmetrical ground glass opacities throughout the lungs which have low lung volumes. CXR AP obtained at 30 days of life (middle) shows prominent bilateral interstitial fibrosis with cystic interstitial changes throughout the lungs which have increased lung volumes. CXR AP obtained at 90 days of life (below) shows faint bilateral interstitial fibrosis with cystic interstitial changes throughout the lungs which have even more increased lung volumes.

Gross Pathology Cases of Wilson Mikity syndrome

Pathology image of Wilson Mikity syndrome / bronchopulmonary dysplasia
Post-mortem gross pathological image of both lungs (above) shows the lungs to have an irregular surface due to the presence of multiple cysts in the lungs. Magnified image (below) better shows the heterogenous nature of the cysts in the lung.