Plastic bronchitis refers to the presence of gelatinous or rubbery casts of the bronchial airway that can plug the peripheral airways. The number may range from few to many.
Causes may include:
(1) congenital heart disease, especially after surgical correction (Fontan surgery, repair of the tetralogy of Fallot, other)
(2) asthma
(3) chronic allergic lung disease
(4) bronchiectasis or chronic bronchitis
(5) rheumatoid arthritis
(6) cystic fibrosis
(7) amyloidosis
(8) lung infections (tuberculosis, H1N1 influenza, other)
(9) lymphatic abnormalities
Brogan et al classified the plugs into 2 types based on histologic features:
(1) Type I or inflammatory, with inflammatory cells and fibrin, which is associated with inflammatory disease
(2) Type II or acellular (noninflammatory), which is typically associated with congenital heart disease. These results when there is leakage of proteinaceous material across blood vessels or from lymphatics.
