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Related Experiment Video

Updated: May 18, 2026

Non-surgical Intratracheal Instillation of Mice with Analysis of Lungs and Lung Draining Lymph Nodes by Flow Cytometry
08:01

Non-surgical Intratracheal Instillation of Mice with Analysis of Lungs and Lung Draining Lymph Nodes by Flow Cytometry

Published on: May 2, 2011

Lymphoscintigraphy in plastic bronchitis, a pediatric case report.

Dima R Ezmigna1, Wayne J Morgan, Marlys H Witte

  • 1Department of Pediatrics, University of Arizona, Tucson, Arizona 85724, USA. dezmigna@yahoo.com

Pediatric Pulmonology
|September 6, 2012
PubMed
Summary

Plastic bronchitis involves bronchial cast formation. In a patient with congenital heart disease, lymphoscintigraphy revealed lymphatic leakage contributing to cast formation, suggesting a potential treatment target.

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Area of Science:

  • Pulmonary Medicine
  • Cardiology
  • Medical Imaging

Background:

  • Plastic bronchitis (PB) is a rare, severe condition characterized by bronchial cast formation.
  • Underlying causes often involve pulmonary lymphatic abnormalities.
  • Congenital heart disease (CHD), particularly post-Fontan procedure, is a risk factor.

Observation:

  • A 6-year-old male with CHD presented with recurrent respiratory issues.
  • Initial bronchoscopy showed inflammation and mucus, but no casts.
  • PB was diagnosed after the patient expectorated a bronchial cast.

Findings:

  • Cast analysis revealed lymphocytic aggregates, mucin, and fibrin.
  • Lymphoscintigraphy demonstrated abnormal lymphatic collaterals and retrograde lymph reflux.

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  • This indicated thoracic duct lymph leakage into the tracheobronchial tree.

    • Implications:

    • High intrathoracic lymphatic pressure and retrograde flow may cause recurrent cast formation in post-Fontan patients.
    • Identifying lymphatic defects is crucial for managing PB.
    • Lymphoscintigraphy offers a safer alternative to lymphangiography for diagnosing lymphatic abnormalities.