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Joseph Junewick, MD FACR
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Mucoid Impaction - Cystic Fibrosis

Case Detail

Anatomy: Chest
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 6 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CT
Activities:
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History

Teenager with cystic fibrosis and worsening pulmonary function.


Case Images


Diagnosis

Mucoid Impaction – Cystic Fibrosis

Findings

CT – Multisegment branching opacities and bronchiectasis.

Discussion

Mucoid impaction of the large airways often manifests as tubular opacities referred to as the “finger-in-glove” sign. Segmental bronchial atresia and cystic fibrosis are the most common congenital conditions accounting for mucoid impaction; inflammatory and infectious diseases (allergic bronchopulmonary aspergillosis, broncholithiasis, and foreign body aspiration), benign neoplastic processes (bronchial hamartoma, lipoma, and papillomatosis), and malignancies (bronchogenic carcinoma, carcinoid tumor, and metastases) are the most common acquired processes. Cystic fibrosis, is the result of a defective chloride channel (chromosome 7 mutations), resulting in thick mucoid secretions that are difficult to clear from the airways and, eventually infection. The elicited inflammatory response damages the airways leading to bronchiectasis. Radiographic findings include hyperinflation, finger in glove opacities, peribronchial thickening, bronchiectasis and atelectasis.

Reference

Masrtinez S, Heyneman LE, McAdams HP, et al. Mucoid Impactions: Finger-in-Glove Sign and Other CT and Radiographic Features. RadioGraphics (2008); 28:1369-1382.



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