Bronchiectasis (Acquired, Congenital)

Bronchiectasis is caused by damage to the walls of the bronchi; this damage consists of destroying the smooth muscles and the elastic tissue that allow the bronchial tubes to contract. Consequently, if the bronchi are damaged, secretions that are normally produced in the lung are not well removed and cause an increased likelihood that infections (pneumonia, bronchitis) can develop. Unfortunately these infections can cause further damage to the bronchial walls producing a cycle of increased damaged and then increased infection. As the cycle continues, lung functionality decreases.

As stated previously, the causes can be acquired (infection, environmental exposure, drug and/or alcohol abuse, for example) and/or congenital (alpha-1 antitrypsin deficiency, immotile cilia syndrome, for example).

Some researchers have described three primary types of bronchiectasis. These types are defined by their anatomical/microscopic appearance.

1. Cylindrical bronchiectasis, the mildest form of bronchiectasis that shows the loss of normal airway tapering.
2. Saccular or varicose bronchiectasis shows further distortion of the airway wall along with more mucous and sputum production by the individual; some of the bronchi may appear to be in a beaded form.
3. The most severe form of bronchiectasis and the least common form is cystic bronchiectasis. This form has large air spaces and a honeycombed appearance in CT scan studies and usually has thicker walls than the blebs seen with emphysema. Some people have more than one type in their lungs.