What are the causes of bronchovascular issues?

From the Guidelines

Bronchovascular issues are primarily caused by chronic bronchitis, asthma, and gastroesophageal reflux disease (GERD).

Common Causes of Bronchovascular Issues

• Chronic bronchitis: a disease of the bronchi that is manifested by cough and sputum expectoration occurring on most days for at least 3 months of the year and for at least 2 consecutive years 1
• Asthma: a condition that can cause cough, wheezing, and shortness of breath, and can be triggered by a variety of factors, including allergens and irritants 1
• Gastroesophageal reflux disease (GERD): a condition in which stomach acid flows back up into the esophagus, causing symptoms such as heartburn and cough 1

Uncommon Causes of Bronchovascular Issues

• Tracheobronchomalacia: a condition in which the airways are weakened and can collapse, leading to cough and shortness of breath 1
• Airway stenosis/strictures: a condition in which the airways are narrowed or blocked, leading to cough and shortness of breath 1
• Asbestos exposure: can cause chronic airway obstruction and small airway disease, leading to cough and shortness of breath 1

Diagnosis and Treatment

Diagnosis of bronchovascular issues typically involves a combination of medical history, physical examination, and diagnostic tests such as chest radiographs and high-resolution CT (HRCT) scans 1. Treatment depends on the underlying cause of the bronchovascular issue, but may include medications such as inhaled corticosteroids and bronchodilators, as well as lifestyle changes such as smoking cessation and avoidance of triggers 1.

From the Research

Causes of Bronchovascular Issues

The causes of bronchovascular issues can be diverse and involve various diseases and conditions. Some of the key causes include:

• Diseases affecting the peribronchovascular interstitium, such as sarcoidosis, pulmonary lymphangitic carcinomatosis, silicosis, and lymphoproliferative disorders 2
• Conditions that mainly affect the peribronchovascular interstitium without a predominant perilymphatic distribution, including hydrostatic pulmonary edema, cryptogenic organizing pneumonia, Kaposi's sarcoma, interstitial pulmonary emphysema, and interstitial hemorrhage 2
• Developmental abnormalities of the tracheobronchial tree and its vascular components, which can occur as pure bronchial anomalies, pure vascular anomalies, or combined bronchial and vascular anomalies 3
• Bronchovascular injury associated with clinically significant hemoptysis after CT-guided core biopsy of the lung, which can be caused by penetration of bronchovascular structures along the trajectory of the introducer needle or potential penetration at the firing of the biopsy gun 4

Disease Processes

Disease processes associated with the peribronchovascular region can present in various ways on CT imaging, including:

• Diffuse thickening
• Fibrosis
• Masses or masslike consolidation
• Ground-glass or air space consolidation
• Cysts 5 These presentations can be used to categorize diseases and formulate a differential diagnosis.

Associated Factors

Associated factors for clinically significant hemoptysis after percutaneous transthoracic needle biopsy (PTNB) include:

• Potential penetration of a pulmonary vessel or bronchus 1 mm or larger at firing 4
• Cutting injury of a pulmonary vessel 1 mm or larger or a bronchial structure 4 These factors can be used to assess the risk of clinically significant hemoptysis and guide patient management.