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Primary Pulmonary Lymphatic Flow Disorder Associated Plastic Bronchitis
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  • Xiaoyan Zhang,
  • Jinrong Liu,
  • hui xu,
  • haiming yang,
  • Shunying Zhao
Xiaoyan Zhang
Beijing Children's Hospital Capital Medical University

Corresponding Author:zhangxiaoyansy@163.com

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Jinrong Liu
Beijing Children’s Hospital Affiliated to Capital Medical University
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hui xu
Beijing Children's Hospital
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haiming yang
Beijing Children's Hospital
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Shunying Zhao
Beijing Children's Hospital
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Abstract

Lymphatic plastic bronchitis (PB) most commonly occurs in children with congenital heart disease as a result of secondary pulmonary lymphatic flow disorder (PLFD). However, PB caused by primary PLFD is rare. The clinical symptoms of lymphocytic PB are nonspecific; thus, the diagnosis may be long delayed, especially in the absence of chylothorax. We made a retrospective analysis of two children diagnosed with PB due to primary PLFD, in order to contribute to further understanding of these disorders. Patient 1, an eight-year-old boy, presented with chronic productive cough and expectorated milky-white mucous plugs accompanied by intermitted wheezing for one year. Patient 2, a nine-month-old girl, presented with episodes of acute respiratory distress with expectoration of milky-white bronchial casts for four months. There was no obvious evidence of infection in either child. Bilateral thickening of bronchovascular bundles and interlobular septal, as well as multiple patchy ground-glass opacities were seen on chest computed tomography (CT) in both patients. Lymphangioscintigraphy demonstrated pulmonary lymph reflux in both patients and slowed lymphatic drainage of the lower limbs in patient 1. Primary PLFD was considered for both patients, and a diagnosis of yellow nail syndrome was made in patient 1. Both patients received lymphatic interventional treatment, but all experienced recurrence following the procedure.
02 Jan 2022Submitted to Pediatric Pulmonology
03 Jan 2022Submission Checks Completed
03 Jan 2022Assigned to Editor
10 Jan 2022Reviewer(s) Assigned
03 Mar 2022Review(s) Completed, Editorial Evaluation Pending
05 Mar 2022Editorial Decision: Revise Major
22 May 20221st Revision Received
23 May 2022Assigned to Editor
23 May 2022Submission Checks Completed
23 May 2022Reviewer(s) Assigned
22 Jul 2022Review(s) Completed, Editorial Evaluation Pending
01 Aug 2022Editorial Decision: Revise Minor
14 Aug 20222nd Revision Received
28 Aug 2022Submission Checks Completed
28 Aug 2022Assigned to Editor
28 Aug 2022Reviewer(s) Assigned
06 Oct 2022Review(s) Completed, Editorial Evaluation Pending
08 Oct 2022Editorial Decision: Revise Minor
16 Oct 20223rd Revision Received
17 Oct 2022Assigned to Editor
17 Oct 2022Submission Checks Completed
17 Oct 2022Review(s) Completed, Editorial Evaluation Pending
17 Oct 2022Reviewer(s) Assigned
02 Nov 2022Editorial Decision: Accept