page_title: Plastic bronchitis
section_title: Diagnosis
hierarchical_section_title: Plastic bronchitis / Diagnosis
caption_attribution_description: Photo of plastic bronchitis specimen.
context_page_description: Plastic bronchitis is a disorder in which branching casts of the airways are expectorated. PB is not a single disease with a defined mechanism that explains the cast formation in all conditions. Examples of diseases associated with expectoration of casts, and which sometimes are labeled PB include tuberculosis, atypical mycobacterial disease, allergic bronchopulmonary aspergillosis and asthma.
  When casts are very large with many branches, an abnormal communication or leakage of lymphatic fluid into the airway is often the cause. This entity is termed lymphatic plastic bronchitis. LPB is a lymphatic flow disorder characterized by the recurrent formation of branching, rubbery bronchial casts composed primarily of proteinaceous and sometimes chylous material and lymphocytes. Lymphatic fluids deposited into the airspaces become gelatinous as they cool, forming large string cheese-like casts of the airways, which can obstruct airflow. Attempts to expectorate casts can be quite frightening, leading to fears of asphyxiation.
context_section_description: The diagnosis of plastic bronchitis is confirmed by recovery of casts that have been coughed up or visualized during a bronchoscopy.  There is no specific cytologic, pathologic or laboratory test that is diagnostic for casts due to lymphatic PB.
caption: Plastic bronchitis cast
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