PMC7218211_01
Findings on chest radiography and computed tomography (CT) on admission. A. Chest radiography showed infiltrative shadow on the right middle field. B. Chest CT disclosed gloved finger sign along broncho-vascular bundles with the formation of mucoid impaction in superior segment of right lower lobe (white arrow).
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His chest X-ray showed infiltrative shadow on the right hilar to inferior lunch mediastinum (Fig. 1A). His CT showed a globed finger sign along the broncho-vascular bundles, the formation of mucoid impaction, and the air density in the distal bronchus of the superior segment in the right lower lobe (Fig. 1B).
Findings on the bronchoscopy. The membranous portion of right truncus intermedius was rotated about 90  to the right (black arrows), and bronchus of superior segment of right inferior lobe was absent.
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In his bronchoscopy result, the membranous portion of the right truncus intermedius was rotated about 90  to the right and no bronchial bifurcation in the region where the right B6 should be located (Fig. 2).
Pathological findings. A. The gross appearance of hilar aspect. A dilated bronchus was filled with mucus. B. Microscopically, foam cells, lymphocytes, and plasma cells filled the alveolar space. C. Dilated bronchi seen with the minute and fragile cartilage tissue was sparsely distributed, the supporting tissue was thin, and there was almost no bronchial gland distribution.
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A yellowish, white area and a dilated bronchi filled with mucus was appeared in the specimen (Fig. 3A). These finding indicated that the patient developed obstructive pneumonia (Fig. 3B). Also on Fig. 3C, the fine and fragile cartilage tissues were sparsely spread out, the supporting tissues were thin, and almost no bronchial gland was distributed.