O que causa nódulos de árvore em brotamento nos pulmões?
A causa clássica do padrão de árvore em brotamento étuberculose pós-primária(Fig. 3A, 3B), uma condição que se desenvolve em aproximadamente 5% dos pacientes com infecção primária e está frequentemente associada à desnutrição e à imunossupressão. Ocasionalmente, pode refletir a reinfecção com novos organismos.
O padrão de árvore em brotamento visto na TC representasequelas radiológicas de um processo infeccioso ou inflamatório. Geralmente, isso geralmente resulta em espessamento da parede brônquica com substituição do lúmen normalmente cheio de ar por muco ou pus.
Distúrbios infecciosos pulmonares envolvendo as pequenas vias aéreassão as causas mais comuns do sinal de árvore em botão (,2). Qualquer organismo infeccioso, incluindo agentes bacterianos, micobacterianos, virais, parasitários e fúngicos, pode envolver as pequenas vias aéreas e causar um padrão de árvore em brotamento.
As opacidades de árvore em brotamento (TIB) são um achado de imagem comum na tomografia computadorizada torácica. Essas opacidades pequenas, agrupadas, ramificadas e nodulares representamimpactação mucosa das vias aéreas terminais com inflamação peribronquiolar adjacente.
As causas mais comuns de nódulos pulmonares sãotecido inflamado devido a uma infecção ou inflamação (chamados granulomas) ou tumores pulmonares benignos (como hamartomas). Os nódulos pulmonares malignos menos comuns são geralmente causados por câncer de pulmão ou outros tipos de câncer que se espalharam para os pulmões (câncer metastático).
Nódulos pulmonares malignos indicam câncer e requerem atenção médica e cirurgia. Existem muitas maneiras de reduzir a probabilidade de nódulos pulmonares malignos e melhorar a saúde pulmonar geral:Pare de fumar/Não comece.Envolva-se em exercícios que promovam a saúde pulmonar, como corrida, ioga, caminhadas, etc.
O sinal de 'árvore em botão' éum achado radiológico comum na TCAR. Foi descrito pela primeira vez como uma disseminação endobrônquica em M. tuberculosis [3].
Árvore em botão (Fig. 1) refere-se aum padrão observado na TC de tórax de corte fino no qual a dilatação brônquica centrolobular e o preenchimento por muco, pus ou líquido se assemelham a uma árvore brotando(Figura 2).
Consolidação e opacidades em árvore em brotamento (padrão de broncopneumonia) foram geralmente atribuídas a infecção bacteriana e pneumonia por aspiração.
O sinal ou padrão de árvore em brotamento descreve a aparência CT demúltiplas áreas de nódulos centrolobulares com um padrão de ramificação linear. Embora inicialmente descrita em pacientes com tuberculose endobrônquica, ela é agora reconhecida em um grande número de condições.
O que é a inflamação da árvore em brotamento?
O sinal da árvore em brotamento reflete a presença de bronquíolos centrolobulares dilatados com lúmens impactados por muco, líquido ou pus; é frequentemente associado ainflamação peribronquiolar.
A malignidade pode estar associada ao sinal de 'árvore em botão'. A embolia tumoral pulmonar intravascular geralmente ocorre em cânceres de mama, fígado, rim, estômago, próstata e ovários e pode levar ao sinal da árvore em brotamento na TCAR [2,14].
A maioria dos nódulos pulmonares é benigna ou não cancerosa. Na verdade, apenas 3 ou 4 em 100 nódulos pulmonares acabam sendo cancerígenos, ou menos de cinco por cento. Mas,nódulos pulmonares devem sempre ser avaliados para câncer, mesmo que sejam pequenos.
Como os nódulos pulmonares são gerenciados ou tratados? Nódulos pulmonares pequenos e não cancerosos geralmente não requerem tratamento. Você pode precisar de tratamentos, comoantibióticos ou medicamentos antifúngicos, se você tiver uma infecção. Se o nódulo crescer, causar problemas ou for canceroso, você pode precisar de cirurgia.
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