Large Bronchial Casts

Unusually large bronchial casts developed in four patients. In two, the casts were associated with pneumonia. In one, a large RBC cast resulted from a complication of fiberoptic bronchoscopy. Bronchial casts developed in an additional patient as a manifestation of plastic bronchitis. Although unusual, bronchial cast formation may complicate a number of hypersecretory pulmonary diseases. Therapy ordinarily includes specific measures to treat the underlying disease state and maneuvers designed to remove or facilitate the expectoration of bronchial casts.