Chronic aspiration pneumonitis

Chronic aspiration pneumonia occurs when recurrent episodes of aspirated particles lead to chronic granulomatous inflammation of the airways and lungs.

This article will focus on the chronic form of aspiration (c.f. acute aspiration pneumonia), for a broader discussion, please, refer to the parental article on aspiration pneumonia.

Pathology

This results from the repeated passage of food material, gastro-esophageal reflux content, and/or saliva into the sub-glottic airways and then into the lungs over a prolonged period of time.

Radiographic features

CT

Direct features

Findings can vary dependent on the duration and amount of content and involves mainly dependent lung regions although at times can have a random distribution.

While each feature on its own can be non-specific, chronic aspiration changes can include a combination of:

• centrilobular nodules: common
• ground-glass opacities: common
• small foci of consolidation
• lung architectural distortion 
  • prominent septal lines
    • reticular interstitial pattern
  • regions of bronchiectasis / bronchioloectasis: especially lower zone predominant - gravity-dependent
• bronchial wall thickening

Indirect features

There may be a predisposing factor for aspiration such as hiatus hernia, features supportive of reflux or a stroke in clinical history or other imaging.

See also

• pulmonary aspiration diseases
  • aspiration bronchiolitis

Siehe auch:

• Bronchiektasen
• Aspiration
• Aspirationspneumonie
• akute Aspirationspneumonie