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Plugs of the Air Passages: A Clinicopathologic Review
Tanmay S Panchabhai1, Sanjay Mukhopadhyay2, Sameep Sehgal3
1Norton Thoracic Institute, St Joseph's Hospital and Medical Center, Phoenix, AZ.
Abstract:
Although mucus is a normal product of the tracheobronchial tree, some diseases of the respiratory tract are characterized by unusually thick (inspissated) forms of mucus that accumulate within the airways. These are known as mucus plugs. The pathologic composition of these plugs is surprisingly diverse and, in many cases, correlates with distinctive clinical, radiologic, and bronchoscopic findings. The best-known conditions that involve mucus plugs are allergic bronchopulmonary aspergillosis, plastic bronchitis, and asthma. Other lung diseases occasionally associated with plugs within the airways include Aspergillus tracheobronchitis, hyper-IgE syndrome, exogenous lipoid pneumonia, pulmonary alveolar proteinosis, and chronic eosinophilic pneumonia. In this review, we describe and illustrate the bronchoscopic, pathologic, and imaging findings in respiratory disorders characterized by mucus plugs or plugs composed of other similar materials. Recognition of the characteristic appearance and differential diagnosis of mucus plugs will hopefully facilitate diagnosis and management of these diseases.
Insights
Respiratory diseases can cause thick mucus plugs in airways. This review details their diverse pathology and diagnostic findings across conditions like allergic bronchopulmonary aspergillosis and asthma.
Area of Science:
- Pulmonology
- Pathology
- Radiology
Background:
- Mucus plugs are inspissated mucus accumulations in the tracheobronchial tree.
- Their diverse pathologic composition often correlates with specific clinical presentations.
Purpose of the Study:
- To review and illustrate the findings associated with mucus plugs in various respiratory disorders.
- To aid in the diagnosis and management of diseases characterized by airway plugs.
Main Methods:
- Review of bronchoscopic, pathologic, and imaging findings.
- Correlation of findings with clinical, radiologic, and bronchoscopic data.
Main Results:
- Mucus plugs are found in conditions including allergic bronchopulmonary aspergillosis, plastic bronchitis, and asthma.
- Other associated conditions include Aspergillus tracheobronchitis, hyper-IgE syndrome, and chronic eosinophilic pneumonia.
- Pathologic diversity of plugs is noted, with characteristic findings for each disease.
Conclusions:
- Recognition of mucus plug appearance and differential diagnosis is crucial.
- Facilitating diagnosis and management of these respiratory conditions.
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