title: Tracheobronchial Branching Abnormalities: Lobe-based Classification Scheme.
abstract: Boyden's nomenclature, which was based on postmortem specimens and published in 1955 prior to the advent of computed tomography (CT), is commonly used to describe the normal segmental bronchial anatomy and various abnormalities. However, several additional anomalies have been recognized since that time, and there is some confusion over the names used to describe these anomalies. Several congenital branching anomalies affecting the trachea, main bronchi, and intermediate bronchus have been reported, all of which can be recognized at chest CT but are often overlooked. These anomalies, which probably occur early in fetal life, can be either supernumerary, with defects occurring at 29-30 days gestation, or displaced, with defects occurring later. Tracheobronchial positional anomalies are often associated with other congenital abnormalities but may be isolated. They often are asymptomatic but can be responsible for pulmonary symptoms such as dyspnea, recurrent pneumonia, and hemoptysis. It is essential that these anomalies are recognized prior to lung resection to avoid complications, especially when video-assisted thoracoscopic surgery is performed. In addition, bronchoscopists should be aware of these anomalies before performing diagnostic or therapeutic bronchoscopic procedures. Awareness of a few key bronchial anatomic principles and use of a lobe-based classification scheme will facilitate recognition of tracheobronchial positional anomalies.
authors.affiliation: From the Department of Radiology, Hôpital Clocheville-CHU Tours, 49 Boulevard Béranger, 37044 Tours, France (G.C., E.C., D.S.); and Department of Radiology, Hôpital Armand Trousseau, Paris, France (B.M., H.D.L.P.).
authors.forename: Guillaume
authors.initials: G
authors.lastname: Chassagnon
authors.affiliation: From the Department of Radiology, Hôpital Clocheville-CHU Tours, 49 Boulevard Béranger, 37044 Tours, France (G.C., E.C., D.S.); and Department of Radiology, Hôpital Armand Trousseau, Paris, France (B.M., H.D.L.P.).
authors.forename: Baptiste
authors.initials: B
authors.lastname: Morel
authors.affiliation: From the Department of Radiology, Hôpital Clocheville-CHU Tours, 49 Boulevard Béranger, 37044 Tours, France (G.C., E.C., D.S.); and Department of Radiology, Hôpital Armand Trousseau, Paris, France (B.M., H.D.L.P.).
authors.forename: Elodie
authors.initials: E
authors.lastname: Carpentier
authors.affiliation: From the Department of Radiology, Hôpital Clocheville-CHU Tours, 49 Boulevard Béranger, 37044 Tours, France (G.C., E.C., D.S.); and Department of Radiology, Hôpital Armand Trousseau, Paris, France (B.M., H.D.L.P.).
authors.forename: Hubert
authors.initials: H
authors.lastname: Ducou Le Pointe
authors.affiliation: From the Department of Radiology, Hôpital Clocheville-CHU Tours, 49 Boulevard Béranger, 37044 Tours, France (G.C., E.C., D.S.); and Department of Radiology, Hôpital Armand Trousseau, Paris, France (B.M., H.D.L.P.).
authors.forename: Dominique
authors.initials: D
authors.lastname: Sirinelli
mesh_terms: D000015:Abnormalities, Multiple / Q000145:classification / Q000000981:diagnostic imaging / Q000196:embryology; D001980:Bronchi / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000196:embryology; D001999:Bronchoscopy; D000013:Congenital Abnormalities / Q000145:classification / Q000000981:diagnostic imaging / Q000196:embryology; D006801:Humans; D021621:Imaging, Three-Dimensional; D008168:Lung / Q000002:abnormalities / Q000196:embryology; D012120:Respiration Disorders / Q000209:etiology; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000196:embryology