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Chronic Pulmonary Microaspiration: High-resolution Computed Tomographic Findings in 13 Patients

Pereira-Silva, Jorge L. MD, PhD*; Silva, Cleonice Isabela S. MD, PhD; Araújo Neto, Cesar A. MD, PhD; Andrade, Thamine L. MD§; Müller, Nestor L. MD, PhD

doi: 10.1097/RTI.0000000000000091
Original Articles

Purpose: The aim of the study was to describe the high-resolution computed tomography (CT) manifestations of chronic pulmonary microaspiration, a condition characterized by recurrent subclinical aspiration of small droplets of gastric contents or foreign particles into the lungs.

Materials and Methods: We reviewed the CT findings in 13 consecutive patients with clinical (n=13) and histologic (n=1) diagnosis of chronic pulmonary microaspiration. Twelve patients presented with persistent cough, but none had a clinical history of acute aspiration. One patient was asymptomatic. All patients had volumetric CT of the chest reconstructed using thin sections (1 to 1.3 mm) at the time of diagnosis. The CT scans were interpreted by 3 chest radiologists who reached a final decision by consensus.

Results: All 13 patients had centrilobular nodules and ground-glass opacities that involved mainly the dependent lung regions in 11 patients and had a random distribution in 2. Other common findings included branching opacities (n=10), small foci of consolidation (n=7), septal lines (n=5), and bronchiectasis (n=7). The 13 patients had at least 1 risk factor for aspiration including gastroesophageal reflux (n=9), hiatus hernia (n=6), esophageal dysfunction (n=3), oropharyngeal dysphagia (n=1), esophageal carcinoma (n=1), and use of sedatives (n=2).

Conclusions: The high-resolution CT manifestations of chronic pulmonary microaspiration consist mainly of centrilobular nodules and ground-glass opacities that tend to involve predominately the dependent regions. Branching opacities and small foci of consolidation are seen in the majority of cases.

*Faculty of Medicine, Department of Pulmonary Medicine, Federal University of Bahia

Department of Radiology, Delfin Clinic and Portuguese Hospital

Image Memorial

§Clínica AMO (Assistência Multidisciplinar em Oncologia), Bahia, Brazil

Department of Radiology, University of British Columbia, BC, Canada

The authors declare no conflicts of interest.

Correspondence to: Nestor L. Müller, MD, PhD, Department of Radiology, University of British Columbia, Room 3350, Third Floor, Jim Pattison Pavilion North 950 West 10th Avenue Vancouver, BC, Canada V5Z 4E3 (e-mail:

© 2014 by Lippincott Williams & Wilkins