tree in bud

Tree in bud
Do Hoang Trong


Definition
• TIB opacities, when present, are seen in a centrilobular location.
They may be associated with centrilobular nodules.
• TIB is characterized by the presence of branching opacities, 1 to 2
mm in
thickness and 1 to 2 cm in length, often associated with small
nodules at the tips of the branches or along their length.


• TIB is usually due to dilatation and impaction of centrilobular
bronchioles by pus or mucus (the branches), associated with small
regions of peribronchiolar inflammation or fibrosis (the buds).


Tree in bud

Infection of
small airway
disease

Not specific with regard to the type
of infection


Cause of tree in bud
Bacterial infection
Mycobacterial infection

Fungal infection
Viral infection
Cystic fibrosis
ABPA
Primary ciliary dyskinesia
Immunodeficiency
Diffuse panbronchiolitis
Follicular bronchiolitis
Invasive mucinous adenocarcinoma
Aspiration


Pneumonia


Pneumonia



Primary ciliary dyskinesia
• Genetic disorder
• Sinutitis
• Conduct hearing loss
• Bronchiectasis and bronchiolitis
• impaired fertility


Primary ciliary dyskinesia

ABPA and TIB


Diffuse panbronchiolitis
• Etiology is unclear, but it is likely that chronic infection play a
significant role.
• If left untreated, DPB progresses to bronchiectasis.
• Daily treatment of DPB with macrolide antibiotics such as
erythromycin eases symptoms and increases survival time, but
the disease currently has no known cure
• The eventual result of DPB can be respiratory failure and heart
problems.


Difuse panbronchiolitis


infection


Tuberculosis


Tuberculosis



Conclusion
• TIB is bronchiectasis and contatin sputum, pus… , so TIB is a sign
of infection

• TIB is not specific for tuberculosis if it come alone


Reference
• Ebook Fundamental HRCT, Brett M Elicker, W Richard Webb