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An endobronchial finding refers to any abnormality or observation
made within the bronchial tubes, usually detected through
bronchoscopy, imaging, or pathology. These findings can include a
range of conditions such as tumors, foreign bodies, mucus plugs,
inflammation, strictures, or infection-related changes within the
bronchial walls.. Diagnosis is generally made through
bronchoscopy, which provides a direct view of the bronchial lining,
along with imaging studies like CT scans, which help in evaluating
the extent and nature of the endobronchial finding. (Etesami)

Endobronchial Finding (Lung)

  • What is it:
    • An “endobronchial finding” refers to an abnormality located within the lumen of the bronchi, visible on imaging or endoscopic evaluation.
    • It may result from various processes, such as neoplasms, infections, foreign bodies, or inflammatory conditions, causing obstruction, narrowing, or structural changes.
  • Etymology:
    • Derived from the Greek words endo- (inside) and bronchos (windpipe), referring to abnormalities within the bronchial passages.
  • AKA:
    • Intrabronchial lesion, bronchial abnormality.
  • How does it appear on each relevant imaging modality:
    • Chest CT (preferred):
      • Parts: May involve a focal mass, nodule, or narrowing within the bronchial lumen.
      • Size: Variable, depending on the underlying cause (e.g., small foreign body vs. large obstructing tumor).
      • Shape: Typically round or lobulated (e.g., tumor) or irregular (e.g., inflammatory or infectious causes).
      • Position: Localized to specific bronchi; may involve segmental, lobar, or mainstem bronchi.
      • Character:
        • Obstructive changes, such as atelectasis or post-obstructive pneumonia.
        • May show calcifications (e.g., in carcinoid tumors).
        • Air trapping on expiratory imaging suggests partial obstruction.
    • Chest X-ray:
      • Often non-specific but may show:
        • Unilateral hyperlucency (air trapping).
        • Collapse of distal lung segments or lobes.
        • Post-obstructive consolidation.
    • Bronchoscopy:
      • Direct visualization of the abnormality, confirming its location, size, and morphology.
      • Useful for biopsy and therapeutic interventions.
  • Differential diagnosis:
    • Neoplastic:
      • Benign: Endobronchial hamartoma, lipoma.
      • Malignant: Primary bronchogenic carcinoma (e.g., squamous cell carcinoma), carcinoid tumor, metastatic lesions.
    • Infectious:
      • Endobronchial tuberculosis.
      • Fungal infections (e.g., aspergillosis).
    • Inflammatory:
      • Sarcoidosis.
      • Endobronchial inflammatory polyps.
    • Mechanical:
      • Foreign body aspiration.
      • Tracheobronchial stenosis (post-traumatic or iatrogenic).
    • Congenital:
      • Bronchial atresia.
  • Recommendations:
    • Further evaluation:
      • Contrast-enhanced CT to assess vascularity and soft tissue characteristics.
      • PET-CT for metabolic assessment if malignancy is suspected.
    • Endoscopic investigation:
      • Bronchoscopy for direct visualization, biopsy, or removal of foreign bodies.
    • Clinical correlation:
      • Assess for symptoms such as wheezing, hemoptysis, recurrent infections, or dyspnea.
  • Key considerations and pearls:
    • Endobronchial findings often cause secondary changes like atelectasis, air trapping, or recurrent pneumonia.
    • Central tumors like squamous cell carcinoma and carcinoid tumors frequently present as endobronchial lesions.
    • Bronchoscopy is critical for confirming the diagnosis, especially when imaging findings are non-specific.
    • Prompt evaluation of endobronchial findings is necessary to prevent complications such as distal infection, obstruction, or airway collapse.