CTICasesCalcified Mucus Plugging in Chronic Mycobacterium Avium Complex (MAC) Infection
Imaging findings
Baseline and five-year follow-up high-resolution CT scans show bronchiectasis and tree-in-bud nodules consistent with chronic atypical mycobacterial infection. Additionally, dense, linear calcifications are seen mapping out the branching anatomy of the dilated right middle lobe bronchi, representing calcified mucous plugs.
Key takeaways
While high-attenuation or calcified mucus plugging is classically associated with allergic bronchopulmonary aspergillosis (ABPA), it can also occur chronically in patients with long-standing atypical mycobacterial infections such as Mycobacterium avium complex (MAC). Over time, retained secretions within bronchiectatic airways can dry out and calcify, producing dense, branching broncholiths.
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