MUCOID IMPACTION OF THE BRONCHI

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Abstract
Summary: Seven cases illustrating the syndrome of mucoid impaction of bronchi are described. The syndrome seems to be confined to asthmatics. It may be clinically silent for long periods, or it may lead to bronchiectasis, pulmonary infection and hæmoptysis. Radiologically it may show both peripheral and hilar components. Diagnostically it may be confused with pulmonary tuberculosis, neoplasm or Loeffler's syndrome.Treatment is primarily medical. Adrenal corticoids may aggravate infection and are contraindicated. Surgical resection may be necessary to remove areas of destroyed lung or when a differentiation from bronchial carcinoma is impossible on clinical grounds.Lobectomy was performed in two cases only in this series, and the examination of operation specimens showed bronchi occluded by eosinophilic mucous material. There was inflammation with disorganization of the bronchial walls, and the alveoli showed collapse and lipoid pneumonia.It is considered that the syndrome described represents a more benign and localized variant of the widespread mucus obstruction of small bronchi found in fatal cases of status asthmaticus, and that both have their basis in a quantitative or qualitative disorder of bronchial mucus secretion in asthmatics. This disorder may be present even when clinical asthma is temporarily absent.

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