On the nature of peculiar expectorated bronchial casts: Can infrared spectroscopy enlighten us?

Bronchial casts can be defined as gelatinous structures originating from the airways. While several cases of bronchial cast formation have been reported in literature, unravelling its nature is often a difficult task. In this case report, we applied infrared (IR) spectroscopy on a bronchial cast fra...

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Bibliographic Details
Published in:Clinica chimica acta 2021-12, Vol.523, p.31-34
Main Authors: De Bruyne, Sander, Ommeslag, Dirk, Himpe, Jonas, Delanghe, Joris, Van Den Abeele, Anne-Marie
Format: Article
Language:English
Subjects:
Bronchial cast
Chyloptysis
Heart Failure
Humans
Infrared spectroscopy
Spectrum Analysis
Sputum
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Summary:Bronchial casts can be defined as gelatinous structures originating from the airways. While several cases of bronchial cast formation have been reported in literature, unravelling its nature is often a difficult task. In this case report, we applied infrared (IR) spectroscopy on a bronchial cast fragment originating from a patient who suffered from a 2-y history of frequent coughing accompanied by the occasional expectoration of viscous and thick white-yellow bronchial-like structures. Based on a markedly high lipid to protein ratio and presence of long-chain fatty acids, the resulting IR spectrum appeared to be very suggestive for chyloptysis. Taking into account the patient’s prior history of radiation therapy for a lymphoma complicated by congestive heart failure, we hypothesized that an impairment of adequate lymphatic flow into the venous system due to a combination of lymphatic obstruction and high venous pressures is the most plausible culprit.
ISSN:0009-8981
1873-3492
DOI:10.1016/j.cca.2021.08.033