PMC4387587_01
Atelectasis of the right lower and middle lobe.
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Fig1
A CT scan showed atelectasis of the right lower and middle lobes (Figure 1).
Plugs blocking the right lower and middle lobar bronchus.
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Fig2
Respironics swivel connector to ensure adequate gas exchange. Right lower and middle lobe bronchi were almost completely occluded by bronchus-shaped plugs (Figure 2).
Bronchus-shaped plug.
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Fig3
The removal of the plugs was very hard despite repeated washings with physiological saline and mechanical fragmentation with forceps (Figure 3).
At histologic examination, the plug consisted mainly of fibrin mixed with some mucus, scattered inflammatory cells, and some small aggregates of bronchial cells. Haematoxylin-Eosin, 40X.
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Fig4
The histological analysis of the plugs demonstrated a massive presence of fibrin with mucus debris, rare Charcot-Leyden crystals, scattered macrophages, neutrophils, eosinophils and bronchial epithelial cells (Figure 4).