J Korean Radiol Soc.  1990 Oct;26(5):948-954. 10.3348/jkrs.1990.26.5.948.

CT Findings of mucoid impaction in 13 cases: speculation on their etiology

• Choi KO

• KMID: 2358812
• DOI: http://doi.org/10.3348/jkrs.1990.26.5.948

Abstract

Mucoid impaction presents a typical appearance on plain radiography and CT. If the lesion is multiple withmanifestations of diffuse bronchopathy, it usually is a medical disease. On the other hand, if the lesion issingle, an effort should be made to determine the underlying disease. The most frequent cause of the latter lesionis lung cancer, which geneally can be depicted by CT. We retrospectively reviewed 13 cases of chest CT withobstructive mucoid impaction, in which CT and BFS(bronchofiberscopy) did not reveal a specific underlying cause.Women in the twenties and thirties were dominant and a past history of pulmonary tuberculosis was present in nine.BFS, done in nine, showed bronchial obstruction, and also luminal narrowing and cicatricial mucosal changesproximal to the obstruction in all of them. Endobronchial tuberculosis was proven in only one case by bronchial wall biopsy. Lobectomy was performed in three. At the bronchial obstruction site, thickened bronchial walls wereconnected to proximal bronchi and there was no evidence of a clear underlying pathology except submucosal fibrosisin all theree. The level of bronchial obstruction, determined by CT and BFS, was in the main bronchus in one,lobar bronchi in six, and divisional or segmental bronchi in seven. CT additionally showed calcific spots in theirparencyma connected to the bronchial obstruction in seven cases, and other changes suggestive of tuberculousorigin in findings of surgical specimen, most , if not all, of these 13 lesions are supposed to be a sequela of endobronchial tuberculosis.

MeSH Terms

Biopsy
Bronchi
Hand
Lung Neoplasms
Pathology
Phenobarbital
Radiography
Retrospective Studies
Tomography, X-Ray Computed
Tuberculosis
Tuberculosis, Pulmonary
Phenobarbital