Understanding Plastic Bronchitis

Understanding Plastic Bronchitis

Brittany Bennet, MA: This animation shows normal lymphatic anatomy and flow. Lymphatic fluid flows from the lower extremities, the liver and intestine, to the thoracic duct, which is the main channel for lymphatic drainage. In most people, the thoracic duct drains into the subclavian vein on the left side.

Now we see lymphatic anatomy and flow in patients with plastic bronchitis. In these patients, lymphatic fluid from the thoracic duct flows backwards into the lymphatics surrounding the airway. This causes inflammation and edema or swelling, and eventually leads to the leakage of lymphatic fluid into the airway. When exposed to air, lymphatic fluid forms casts, which are thick masses of branching, protein-rich material that can make it difficult to breathe and need to be coughed out. In some patients with plastic bronchitis and a normal thoracic duct, the disease can be caused by lymphatic channels that originate from the liver, bypass the thoracic duct and connect directly to the lymphatics surrounding the airway.

Plastic bronchitis is diagnosed with lymphatic imaging. There are multiple treatment options for plastic bronchitis, including medical management, minimally invasive interventions and surgical interventions. Our team will determine the best intervention for you or your child based on your diagnosis and imaging.