A Large Bronchial Cast of an Infant

Abstract

A 16-months old boy was admitted to Jichi Medical Hospital with severe inspiratory dyspnea which had occurred after severe cough attack during supper. Physical findings and X-ray findings strongly suggested a foreign body in the left bronchus. Bronchoscopy was performed under general anesthesia and a large branching cast (4.5cm in the maximum length, 3mm in the maximum diameter, whitish-gray and elastic) was removed from the left main bronchus. Its shape and size well corresponded to the lumen of the left bronchus of this age.From its microscopical findings, it was assumed that this bronchial cast was a product of his own bronchial secretion under several pathological conditions.We referred to the previous reports on plastic bronchitis, mucoid impaction of the bronchus and allergic bronchopulmonary aspergillosis, and concluded that our case was to be classified as a type of mucoid impaction of the bronchus.