Severe adult-type Williams-Campbell syndrome (Williams-Campbell-type bronchiectasis)

A 70-year-old man was admitted to our hospital because of dyspnea. Arterial blood gas analysis indicated severe type-II respiratory failure. Williams-Campbell-type bronchiectasis was suspected because chest radiographs disclosed multiple cystic shadows in both lungs. Although inspiratory chest radiographs and computed tomographic (CT) scans showed cystic bronchiectasis, expiratory chest radiographs and CT scans demonstrated characteristic collapse of the ectatic bronchi. Continuous fluoroscopic visualization of the respiratory phase demonstrated bronchial dilatation during inhalation and collapse during exhalation. Williams-Campbell-type bronchiectasis was diagnosed on the basis of the radiological findings. Compared with previous cases of Williams-Campbell syndrome reported in Japan, this case was interesting because the patient exhibited severe respiratory failure and because the dilatating and collapsing bronchi were demonstrated by fluoroscopy.