Kunishige Michihiro, Takahashi Hiroki, Takahashi Kiyohide, Nishiyama Miho, Sumitomo Kenya, Shinohara Tsutomu
Division of Internal Medicine, Japan Agricultural Cooperatives Kochi Hospital, Nankoku, Japan.
Department of Community Medicine for Respirology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.
J Asthma. 2025 Oct;62(10):1825-1830. doi: 10.1080/02770903.2025.2513063. Epub 2025 Jun 13.
Imaging evaluation of mucoid impaction is important in differentiating allergic bronchopulmonary aspergillosis (ABPA) from other severe asthma cases with or without fungal sensitization.
We encountered a case of mucoid impaction in a 62-year-old man with severe asthma who was positive for anti- IgG antibodies; however, subsequent examination revealed that the cause of wheezing and mucoid impaction was broncholith. While broncholiths can be a direct cause of wheezing due to the associated airway narrowing, mucosal damage caused by broncholiths or fungi attached to them may be an exacerbating factor for asthma. Moreover, mucoid impaction is actually a rare manifestation of broncholiths.
Broncholithiasis should be considered in the differential diagnosis of ABPA and other conditions involving mucoid impaction.
黏液嵌塞的影像学评估对于鉴别变应性支气管肺曲霉病（ABPA）与其他伴有或不伴有真菌致敏的重度哮喘病例至关重要。
我们遇到一名62岁重度哮喘男性患者发生黏液嵌塞，其抗IgG抗体呈阳性；然而，后续检查显示喘息和黏液嵌塞的病因是支气管结石。虽然支气管结石可因相关气道狭窄直接导致喘息，但支气管结石或附着于其上的真菌引起的黏膜损伤可能是哮喘的加重因素。此外，黏液嵌塞实际上是支气管结石的一种罕见表现。
在ABPA和其他涉及黏液嵌塞的疾病的鉴别诊断中应考虑支气管结石症。
