Chest Imaging

Accessory cardiac bronchus

supernumerary bronchus arising from the medial wall of the bronchus intermedius, between the upper lobe and right middle lobe bronchi. Its appearance may range from a short diverticulum to a longer bronchus with distal alveolar arborization (Fig.1). A small enhancing soft tissue mass when using CT with contrast medium can correspond to vestigial parenchyma. Although this congenital abnormality is usually asymptomatic, it may be responsible for migration of infected material in the right lower lobe. The differential diagnosis includes congenital broncho oesophageal fistula, bronchial fistulization of a tuberculous lymph node, acquired diverticula, adenolectasia and mucous strands in the intermediate bronchus. For normal anatomy, see bronchial tree.

JR - MRJ

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Fig.1

Accessory cardiac bronchus appearing as an intraparenchymal diverticulum (arrow) parallel to the intermediate bronchus.
Accessory cardiac bronchus, Fig.1