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feat: Add new articles on Allergic Bronchopulmonary Aspergillosis, Finger-in-Glove Sign, and Tracheal Dilatation; update content index and document conversion script

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docs_md/articles/allergic-bronchopulmonary-aspergillosis_81c5db2f-b8f6-4092-bcd2-ffb8aa3ab18a.md
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---
title: "Allergic Bronchopulmonary Aspergillosis"
docid: "81c5db2f-b8f6-4092-bcd2-ffb8aa3ab18a"
breadcrumbs:
- "Chest"
- "Differential Diagnosis"
- "Airways"
- "General Imaging Patterns"
- "Finger-in-Glove Sign"
---
# ESSENTIAL INFORMATION
- ## Key Differential Diagnosis Issues
- Finger-in-glove sign: Mucoid impaction with resultant dilated or impacted bronchi
- Bronchial obstruction: Atresia, foreign body, neoplasm
- Nonobstructive entities: Allergic bronchopulmonary aspergillosis, cystic fibrosis
- Radiography/CT: Branching tubular opacities that typically radiate from hilum toward lung periphery
- Differential diagnosis of bronchial branching tubular opacities
- Arteriovenous malformation
- Exhibits contrast enhancement
- Demonstrates afferent and efferent vessels: Feeding artery(ies) and draining vein(s)
- ## Helpful Clues for Common Diagnoses
- **Allergic Bronchopulmonary Aspergillosis**
- Immunologic disorder caused by hypersensitivity to*Aspergillus fumigatus*
- Predisposing conditions: Asthma, cystic fibrosis
- Laboratory findings: Positive aspergillus skin test, elevated IgE levels against *Aspergillus fumigatus*
- Total IgE levels > 1,000 IU/mL
- IgG antibodies against*A. fumigatus* in serum
- Total eosinophil count > 500 cells/mL
- Imaging: Branching tubular opacities, high attenuation on CT due to intrinsic calcium oxalate
- **Congenital Bronchial Atresia**
- Focal atresia of segmental bronchus
- Typically affects left upper lobe apicoposterior segment
- Recurrent infection in 20% of patients
- CT: Tubular or branching opacity surrounded by hyperlucent lung due to air-trapping and oligemia
- ## Helpful Clues for Less Common Diagnoses
- **Bronchiectasis**
- Cystic fibrosis
- Autosomal recessive disorder that affects regulation of chloride transport
- Recurrent infection, progressive bronchial wall injury
- Diffuse bronchiectasis (upper lobe predominant); central and peripheral airways affected
- Primary ciliary dyskinesia
- Structural abnormality that affects ciliary motion
- Bronchiectasis, sinusitis, infertility
- Basilar predominant airway involvement
- **Benign Airway Neoplasm**
- Hamartoma
- Endobronchial (1.4% of cases)
- Fat &/or calcification in endobronchial lesion supports diagnosis
- Lipoma
- Endobronchial lipoma (0.1-0.5% of lung tumors)
- Nonenhancing homogeneous fat attenuation lesion
- **Malignant Airway Neoplasm**
- Carcinoid tumor
- Low-grade neuroendocrine neoplasm
- Intrinsic calcification; may be eccentric
- Marked contrast enhancement
- Lung cancer
- Centrally obstructing mass
- Mucoid impaction uncommon
- **Foreign Body**
- Patients < 15 years of age (70%)
- Most frequent location: Right lower lobe bronchus and bronchus intermedius
- Adults: Chronic clinical course, recurrent pneumonia
docs_md/articles/finger-in-glove-sign_81c5db2f-b8f6-4092-bcd2-ffb8aa3ab18a.md
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---
title: "Finger-in-Glove Sign"
docid: "81c5db2f-b8f6-4092-bcd2-ffb8aa3ab18a"
breadcrumbs:
- "Chest"
- "Differential Diagnosis"
- "Airways"
- "General Imaging Patterns"
- "Finger-in-Glove Sign"
---
# ESSENTIAL INFORMATION
- ## Key Differential Diagnosis Issues
- Finger-in-glove sign: Mucoid impaction with resultant dilated or impacted bronchi
- Bronchial obstruction: Atresia, foreign body, neoplasm
- Nonobstructive entities: Allergic bronchopulmonary aspergillosis, cystic fibrosis
- Radiography/CT: Branching tubular opacities that typically radiate from hilum toward lung periphery
- Differential diagnosis of bronchial branching tubular opacities
- Arteriovenous malformation
- Exhibits contrast enhancement
- Demonstrates afferent and efferent vessels: Feeding artery(ies) and draining vein(s)
- ## Helpful Clues for Common Diagnoses
- **Allergic Bronchopulmonary Aspergillosis**
- Immunologic disorder caused by hypersensitivity to*Aspergillus fumigatus*
- Predisposing conditions: Asthma, cystic fibrosis
- Laboratory findings: Positive aspergillus skin test, elevated IgE levels against *Aspergillus fumigatus*
- Total IgE levels > 1,000 IU/mL
- IgG antibodies against*A. fumigatus* in serum
- Total eosinophil count > 500 cells/mL
- Imaging: Branching tubular opacities, high attenuation on CT due to intrinsic calcium oxalate
- **Congenital Bronchial Atresia**
- Focal atresia of segmental bronchus
- Typically affects left upper lobe apicoposterior segment
- Recurrent infection in 20% of patients
- CT: Tubular or branching opacity surrounded by hyperlucent lung due to air-trapping and oligemia
- ## Helpful Clues for Less Common Diagnoses
- **Bronchiectasis**
- Cystic fibrosis
- Autosomal recessive disorder that affects regulation of chloride transport
- Recurrent infection, progressive bronchial wall injury
- Diffuse bronchiectasis (upper lobe predominant); central and peripheral airways affected
- Primary ciliary dyskinesia
- Structural abnormality that affects ciliary motion
- Bronchiectasis, sinusitis, infertility
- Basilar predominant airway involvement
- **Benign Airway Neoplasm**
- Hamartoma
- Endobronchial (1.4% of cases)
- Fat &/or calcification in endobronchial lesion supports diagnosis
- Lipoma
- Endobronchial lipoma (0.1-0.5% of lung tumors)
- Nonenhancing homogeneous fat attenuation lesion
- **Malignant Airway Neoplasm**
- Carcinoid tumor
- Low-grade neuroendocrine neoplasm
- Intrinsic calcification; may be eccentric
- Marked contrast enhancement
- Lung cancer
- Centrally obstructing mass
- Mucoid impaction uncommon
- **Foreign Body**
- Patients < 15 years of age (70%)
- Most frequent location: Right lower lobe bronchus and bronchus intermedius
- Adults: Chronic clinical course, recurrent pneumonia
docs_md/articles/tracheal-dilatation_25c1fd77-52ff-4a56-b5c4-6ee1335ba369.md
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---
title: "Tracheal Dilatation"
docid: "25c1fd77-52ff-4a56-b5c4-6ee1335ba369"
breadcrumbs:
- "Chest"
- "Differential Diagnosis"
- "Airways"
- "General Imaging Patterns"
- "Tracheal Dilatation"
---
# ESSENTIAL INFORMATION
- ## Key Differential Diagnosis Issues
- Tracheal wall composed of several layers: Mucosa, submucosa, cartilage or muscle, and adventitia
- Horseshoe-shaped bands of hyaline cartilage support anterior and lateral tracheal walls
- Posterior tracheal wall lacks cartilage and is supported by band of smooth muscle
- During expiration: Anterior bulging of posterior wall of intrathoracic trachea and ↓ of tracheal AP diameter by 32%
- Tracheal dilatation
- Women
- Tracheal transverse diameter > 21 mm, sagittal diameter > 23 mm
- Men
- Tracheal transverse diameter > 25 mm, sagittal diameter > 27 mm
- Tracheal index: Coronal diameter/sagittal diameter measured 1 cm above aortic arch
- Normal index ~ 1
- ## Helpful Clues for Common Diagnoses
- **Upper Lobe Fibrosis**
- Retraction of tracheobronchial walls
- Tuberculosis
- Sarcoidosis
- Hypersensitivity pneumonitis
- **Overdistention of Endotracheal Tube Cuff**
- Endotracheal tube or tracheostomy cannula cuff should not result in tracheal wall bulging
- Endotracheal cuff located 2 cm from distal end
- Overinflation of balloon to 1.5x diameter of normal trachea is associated with tracheal injury
- **Saber-Sheath Trachea**
- ↓ in coronal diameter of intrathoracic trachea associated with ↑ in sagittal diameter
- Associated with COPD (95%)
- Likely related to abnormal intrathoracic pressure
- **Tracheobronchomalacia**
- Condition characterized by excessive airway collapsibility caused by weakness of airway walls due to softening or destruction of supporting cartilage
- Tracheomalacia patients have dilated and flaccid airway
- ↓ in cross-sectional area > 70% during expiration compared with inspiration is generally considered diagnostic
- ## Helpful Clues for Less Common Diagnoses
- **Tracheal Diverticulum**
- Mucosal herniation through tracheal wall from ↑ intraluminal pressure
- Right posterolateral tracheal wall near thoracic inlet
- Between tracheal cartilaginous and muscular portions
- Communication with tracheal lumen rarely identified
- **Mounier-Kuhn Syndrome**
- Atrophy of muscular and elastic tissues in walls of trachea and mainstem bronchi
- More common in men
- Tracheal diameter > 30 mm (81.2%)
- Bronchiectasis (48.6-57.6%)
- Tracheal wall corrugated due to mucosa herniating between tracheal rings