Traction bronchiectasis on a chest CT report refers to airways (bronchi or bronchioles) that are pulled open or stretched because of nearby scarring or fibrosis (lung tissue damage). This is one of the causes of bronchiectasis that we see on chest imaging reports.   Understanding traction bronchiectasis will help you with your radiology report and to have more informed discussions with your doctor.

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Introduction

Traction bronchiectasis is a radiologic sign, not a disease itself. It signals that lung tissue nearby has been altered—usually by fibrosis, scarring, or distortion. When you see that on an imaging report, it means your lungs show structural changes.

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What Is Traction Bronchiectasis?

Definition and distinction
Traction bronchiectasis is airway dilation (widening) caused by elastic pull or tethering from fibrotic lung tissue around them, rather than from infection or airway damage itself. In essence, the lung’s scar tissue “pulls” on the airway, leading to persistent widening.

This differs from “classical bronchiectasis,” which is primarily caused by repeated infection, inflammation, or airway wall destruction. In classic bronchiectasis, you often see thickened airway walls and mucus plugging. In traction bronchiectasis, the dilation tends to occur adjacent to fibrotic lung areas and lacks dramatic wall thickening or mucus filling.

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How It Appears in Imaging

On CT radiologists will look for:

• Dilated airways (bronchi or bronchioles) that retain branching structure and continuity.

• Surrounding signs of fibrosis – such as reticulation (a network of fine lines), architectural distortion,honeycombing (pattern of lung scarring) or ground-glass changes.

• Volume loss in lung regions, due to scarring and contraction.

• Absence of prominent mucus plugging or wall thickening, which helps distinguish it from other forms of bronchiectasis.

Because fibrosis tends to be patchy, the dilation may appear localized and associated with uneven lung patterns rather than diffuse across the entire lung field.

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Causes and Underlying Conditions

Traction bronchiectasis is most often tied to lung fibrosis or interstitial lung disease (ILD). Some common underlying causes include:

• Idiopathic pulmonary fibrosis (IPF) and usual interstitial pneumonia patterns.

• Connective tissue disease–related lung fibrosis (like rheumatoid arthritis, scleroderma).

• Post-inflammatory scarring following severe lung injury or infection.

• Occupational or environmental exposures (asbestosis, hypersensitivity pneumonitis).

• Progression to honeycombing in late-stage fibrotic disease.

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Clinical Significance of Traction Bronchiectasis

Traction bronchiectasis is considered a marker of irreversible lung damage. In patients with interstitial lung diseases, presence and severity of traction bronchiectasis correlate with worse lung function, more symptoms (shortness of breath, cough), and poorer prognosis.

Key points:

• It suggests fibrosis is established in those lung regions.

• It helps grade disease severity in ILD.

• Its extent may predict disease progression or mortality.

• Because it is generally irreversible, treatment focuses on the underlying disease.

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Tracking Progression Over Time

Radiologists may track traction bronchiectasis severity by visually comparing airway diameter to adjacent arteries or normal bronchi. Serial CT scans can show whether the dilation is stable or worsening.

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What Traction Bronchiectasis Is Not

• It is not reversible.

• It is not simply airway inflammation or acute congestion.

• It is not a symptom but a radiologic pattern.

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Putting Findings in Context

When you see “traction bronchiectasis” in your radiology report, the radiologist is signaling that the lung parenchyma (the lung tissue) around those airways is distorted and scarred. The report usually pairs that finding with other patterns: reticulation, architectural distortion, honeycombing, ground-glass. The overall pattern gives your doctor clues to the underlying lung disease and how advanced it might be.

Your doctor may correlate these imaging findings with your symptoms, lung function tests, blood tests, oxygenation, and clinical history. Imaging is one piece of a larger puzzle.

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Management and Follow-Up

Since traction bronchiectasis indicates structural damage, the goal is not to reverse it but to:

• Treat the underlying cause

• Monitor progression via periodic CT scans and lung function.

• Manage symptoms such as cough, breathlessness, or infection risks.

• Avoid further lung injury (smoking cessation, reducing environmental exposures).

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Conclusion

Traction bronchiectasis is a radiologic term that describes airways stretched open by surrounding fibrotic lung tissue rather than by the airway itself. It is a marker of irreversible structural lung disease, most often tied to lung fibrosis or interstitial lung disease. When mentioned in an imaging report, it indicates that your lung has undergone irreversible changes that your doctor will consider in diagnosis, follow up, and management.

References

https://radiopaedia.org/articles/traction-bronchiectasis

https://pmc.ncbi.nlm.nih.gov/articles/PMC7930316/

https://pubs.rsna.org/doi/abs/10.1148/radiol.212584