Lymphatic Plastic Bronchitis Secondary to Thoracic Duct Stenosis

A 42-year-old male presented with cough productive of thick secretions that had the appearance of branching airway casts (Figures  1 and 2). Symptoms were worse upon consumption of foods with a high fat content and conversely, improved with a low fat diet. Bronchoscopy with bronchoalveolar lavage revealed milky fluid return from the right middle and lower lobes with bronchial casts in the right middle lobe. The bronchoalveola r lavage triglyceride level was 479 mg/dL and histopathologic analysis of the casts with Oil Red O staining showed 76% lipid-laden macrophages consistent with chyloptysis.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Medical image Source Type: research