Endoscopic nomenclature for bronchopulmonary anatomy.

Development of the flexible fiberoptic bronchoscope (FFB) has allowed visualization of the peripheral tracheobronchial tree to the level of fifth-order bronchi. Examination of this area requires an extended anatomic nomenclature to describe the pathology of findings. A system of description is presented that combines the concepts of Jackson and Huber, Boyden, Ikeda, and Weibel into a practical endoscopic shorthand lettering designation for endobronchial anatomy. Using the system, a sub-sub-subsegmental (fifth order) bronchus in the right lung could be designated RB1b1 alpha. The principles are described and illustrated.