title: Plugs of the Air Passages: A Clinicopathologic Review.
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.
authors.affiliation: Norton Thoracic Institute, St Joseph's Hospital and Medical Center, Phoenix, AZ.
authors.forename: Tanmay S
authors.initials: TS
authors.lastname: Panchabhai
authors.affiliation: Department of Pathology, Cleveland Clinic, Cleveland, OH.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Mukhopadhyay
authors.affiliation: Department of Pulmonary Medicine, the Respiratory Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Sameep
authors.initials: S
authors.lastname: Sehgal
authors.affiliation: Department of Thoracic Medicine, Geisinger Medical Center, Danville, PA.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Bandyopadhyay
authors.affiliation: Department of Pulmonary Medicine, the Respiratory Institute, Cleveland Clinic, Cleveland, OH; Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Serpil C
authors.initials: SC
authors.lastname: Erzurum
authors.affiliation: Department of Pulmonary Medicine, the Respiratory Institute, Cleveland Clinic, Cleveland, OH. Electronic address: mehtaa1@ccf.org.
authors.forename: Atul C
authors.initials: AC
authors.lastname: Mehta
mesh_terms: D000402:Airway Obstruction / Q000209:etiology*; D001980:Bronchi; D001999:Bronchoscopy; D006801:Humans; D009093:Mucus / Q000737:chemistry / Q000378:metabolism* / Q000382:microbiology
keywords: airway and airspace diseases; bronchoscopic appearance; bronchoscopy; mucoid pseudotumor; mucus plugging