Accessory cardiac bronchus causing recurrent pulmonary infection

http://dx.doi.org/10.1590/S1806-37132014000400014 it might be associated with small amounts of pulmonary parenchyma.(1,3) Most patients with ACB are asymptomatic, and the anomaly is discovered incidentally during bronchoscopy or imaging studies conducted for unrelated reasons.(1,4) However, an ACB can become symptomatic due to recurrent infection, empyema, hemoptysis, and malignant transformation.(1,2,4,5) These symptoms are caused by the accumulation of secretions in the ACB, leading to inflammation and infection, extensive microvascularization, and hemoptysis, especially when the ACB is long or has an accessory lobe.(2,4) Thus, the short type of ACB tends to be asymptomatic, whereas the accessory-lobed and long diverticular types are more susceptible to complications.(5) Histological examination suggested that the specimen resected from our patient was the accessory bronchus, including an accessory lobe with retained secretions. The finding of scar tissue, but no alveoli, on the peripheral accessory lobe suggested that it had been deteriorated or ruptured by constant infection, leading to bronchopneumonia and empyema.(4) An ACB is not generally visible on chest X-ray, but it can be visualized well with other imaging modalities. Surgical resection of a long ACB or of one with an accessory lobe is advised as soon as symptoms occur.(4,5) In conclusion, pulmonologists and radiologists should recognize normal bronchial anatomy as well as developmental bronchial anomalies because this is important to establish a correct diagnosis. Although an ACB is not pathological per se, it is occasionally associated with clinical symptoms and complications. Accessory cardiac bronchus causing recurrent pulmonary infection