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What Is Peribronchial Cuffing?

J.M. Willhite
J.M. Willhite

Peribronchial cuffing is a term used to describe the thickening of the bronchial wall. Commonly associated with lung disorders, it is a severe condition that impairs lung function, making breathing difficult. 

Treatment is wholly dependent on the underlying condition that triggered the thickening. If left untreated, extensive cuffing can result in significant narrowing of the airways, making it difficult to breathe.

Causes of Peribronchial Cuffing

Thickening of the bronchial wall can be the outcome of several lung conditions, including:

Pneumonia

Peribronchial cuffing occurs when the bronchial passages of the lungs thicken with mucus.
Peribronchial cuffing occurs when the bronchial passages of the lungs thicken with mucus.

Conditions characterized by fluid and mucus accumulation in the lungs, such as bronchitis and pneumonia, are the most common illnesses associated with this problem. Triggered by bacterial infection, a hallmark sign of both conditions is the excessive production of mucus. With nowhere to go, the mucus fills the delicate bronchial passages, ultimately placing them at risk for cuffing and collapse.

Pulmonary Edema

Peribronchial cuffing can be identified by X-ray.
Peribronchial cuffing can be identified by X-ray.

Pulmonary edema is another lung condition that may initiate cuffing. Triggered by the accumulation of fluid in the alveoli, or air sacs in the lungs, pulmonary edema inhibits blood oxygenation. As additional fluid accumulates in the lungs, the bronchial passages become inundated, placing them at risk for collapse.

Research shows that lung diseases such as pulmonary edema and bronchiectasis can cause bronchial wall thickening. Autopsies of patients with peribronchial cuffing revealed that the bronchial wall thickening is due to acute left heart failure.

Cancer

Bronchogenic carcinoma may rarely present as peribronchial cuffing and thickening. According to a study, computerized tomography (CT) scans of cancer patients revealed localized peribronchial thickening. A sign of occult bronchogenic carcinoma.

Thoracic radiographs of bronchoalveolar carcinoma revealed significant peribronchial cuffing. The feature can help in reaching the diagnosis of bronchogenic carcinoma.

Individuals suffering from peribronchial cuffing will experience difficulty breathing.
Individuals suffering from peribronchial cuffing will experience difficulty breathing.

Peribronchial cuffing may also occur with lung cancer. Tumor growth can impair the lung’s ability to clear unnecessary fluid and mucus from its delicate tissues and passages. Individuals with lung cancer often experience shortness of breath and wheezing due to fluid collection. Cancer-related cuffing is generally addressed on an individualized basis and may include the use of medication in addition to anticancer therapies.

Asthma

Bronchial cuffing is evident in bronchial asthma and chronic obstructive bronchitis. It was clarified in the study that there is no link between allergic response and peribronchial cuffing.

Peribronchial wall thickening can be edema expression in the mucous membrane.

Bronchiectasis

Physicians examinine chest radiographs to determine if a patient has peribronchial cuffing.
Physicians examinine chest radiographs to determine if a patient has peribronchial cuffing.

It is a chronic condition in which there is an accumulation of mucus. Airways of the lungs may also widen as a response to bronchiectasis. Long-standing bronchiectasis could lead to peribronchial thickening and cuffing. This thickening results from persistent inflammation and infection of the bronchial tissues.

Bronchial disorders such as bronchiectasis can be present at birth or may be acquired later in life. Peribronchial cuffing is usually a final response to irritants.

Cystic Fibrosis

Chronic lung diseases have an evident link to peribronchial cuffing. The most common cause of chronic lung disease is cystic fibrosis (CF) which is directly linked to bronchial wall thickening.

Bronchitis and pneumonia are characterized by fluid accumulation in the lungs.
Bronchitis and pneumonia are characterized by fluid accumulation in the lungs.

Cystic fibrosis (CF) is a disorder that affects multiple body organs, including the lungs, digestive system, pancreas, etc. The inherited disease can cause bronchial cuffing. High-resolution CT scans (HRCT) taken during acute exacerbations of CF revealed evident peribronchial thickening. 

Thickening of the bronchial wall is a prevalent effect of CF on the lung tissues. This thickening can be accompanied by mucous impaction, hyperinflation, and dilation of the airways. Radiographic scoring systems are developed to assess the extent of pulmonary disease in adults and children.

Cuffing and Associated Bronchial Presentations

Coughing and breathing difficulties are the most common symptoms of the condition. Some other symptoms include:

Chest Infections

Bronchial wall thickening and cuffing are present as recurrent chest infections in children with lung diseases such as bronchiectasis. Streptococcus pneumonia is the bacteria that causes frequent lung infections. High-resolution CT scans revealed that abnormal bronchial tapering sometimes accompanies bronchial thickening.

Wheezing and Breathing Difficulties

Cuffing is regarded as a common symptom of bronchial disorders. Initiated by an accumulation of mucus in the delicate bronchial passages, it can trigger a collapse of the affected wall. Once a passage collapses, the affected tissue appears thicker or cuffs. To properly treat cuffing, it is essential to determine what caused the mucus buildup.

The collapse of an affected wall can decrease the total surface area of the bronchi. This collapse leads to breathing difficulties. The thickened bronchial walls paired with the mucus plugging can lead to whistling sounds during breathing, i.e., wheezing.

Weight Loss

Weight loss is also a common symptom of bronchial disorders. It is frequently present in patients with bronchiectasis and chronic obstructive pulmonary disease (COPD).

Chest Pain

Peribronchial cuffing is a frequent presentation of bronchiectasis. It can also be associated with chest pain, but it is not frequently present in patients with bronchiectasis.

Diagnosing Peribronchial Cuffing

The minute passage collapses associated with cuffing are considered a radiographic sign, meaning that they are visible and easily identified with an X-ray. In addition, other diagnostic tools may be used to determine the underlying cause of peribronchial cuffing, including lung function tests and ultrasound

In some cases, laboratory analysis of mucus and blood may also be performed to confirm a diagnosis.

MRI scans and high-resolution computerized tomography scans (HRCT scans) can also help identify regions of bronchial wall thickening. Studies show that MRI scans are as effective as CT scans (high-resolution) in detecting lung abnormalities such as peribronchial cuffing.

Peribronchial Cuffing Treatment

The treatment strategies for cuffing are primarily aimed at curing the underlying cause. However, symptomatic management of the condition is also necessary.

Treatment for this condition is centered on eliminating fluid and mucus buildup. Bronchitis-induced cuffing generally subsides independently without treatment but, in some cases, can require the use of an inhaler to open the bronchial passages.

Mucolytics (mucus removers) are generally advised for patients with bronchitis and COPD. This therapy clears the triggers that lead to the bronchial wall's thickening and alleviates the symptoms.

Antibiotic medication is given for bacterial-based conditions, such as pneumonia, which help clear the lungs of excess fluid. Antibiotic medications are also given to manage acute exacerbations of bronchiectasis.

Some severe cases might warrant surgery or even a lung transplant

As already mentioned, bronchial wall thickening manifests itself as recurrent infections in children. An antibiotic regimen is necessary for younger patients as well.

How Can I Keep My Bronchial Structures and Lungs Healthy?

You can keep your lungs healthy and bronchial walls strong by following some simple home remedies. Lung cleansing techniques are ideal for people with chronic bronchial conditions such as asthma, cystic fibrosis, and chronic obstructive pulmonary disease (COPD).

The techniques include steam inhalation, changing postures to remove the accumulated mucus from the lungs (postural drainage), and regular exercise. To keep peribronchial cuffing at bay, add green tea and anti-inflammatory foods (such as turmeric, berries, and green vegetables) to your diet.

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Discussion Comments

SkyWhisperer

@David09 - I agree, but lifestyle changes can prevent a lot of these problems. For example, we know that smoking can lead to lung cancer, COPD and bronchitis. This alone is a good reason for people to quit smoking.

Some people think that they can beat the odds however and so they keep smoking. While I admit that not all smokers will come down with these diseases, you’re certainly at a higher risk if you do smoke, so why take the chance?

David09

@everetra - That may be generally good advice overall but I hardly think that it will prevent peribronchial cuffing.

The thing is that the cuffing does not tell you what the underlying problem is. If it happens because someone has pneumonia for example, then they already have bacterial infection.

Changing their diet is not really going to change that. I certainly don’t think it will hurt, but I don’t think it will help that much. You need to give them medication to attack the bacterial infection and that should reduce the mucus building and subsequent cuffing.

everetra

I am not a doctor, but since it’s obvious that mucus is the culprit then I think we can do some things that can reduce mucus buildup.

For example, you can try a mucus free diet, which would be heavy on fruits and vegetables and not so heavy on meats and fats. Nuts and seeds can provide you with your protein needs I think.

I am not saying that this treatment would cure peribronchial cuffing, but I think it would help a lot. Excess mucus is just bad news no matter what the underlying condition is. Mucus is full of proteins where bacteria and all that junk can accumulate.

So the less of it you have in your system the better, and I personally believe that diet can be a start in the right direction.

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    • Peribronchial cuffing occurs when the bronchial passages of the lungs thicken with mucus.
      By: Icons Jewelry
      Peribronchial cuffing occurs when the bronchial passages of the lungs thicken with mucus.
    • Peribronchial cuffing can be identified by X-ray.
      By: creo77
      Peribronchial cuffing can be identified by X-ray.
    • Individuals suffering from peribronchial cuffing will experience difficulty breathing.
      By: zebrik
      Individuals suffering from peribronchial cuffing will experience difficulty breathing.
    • Physicians examinine chest radiographs to determine if a patient has peribronchial cuffing.
      By: snaptitude
      Physicians examinine chest radiographs to determine if a patient has peribronchial cuffing.
    • Bronchitis and pneumonia are characterized by fluid accumulation in the lungs.
      By: decade3d
      Bronchitis and pneumonia are characterized by fluid accumulation in the lungs.