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Plastic bronchitis is an uncommon and underdiagnosed entity, characterized by recurrent expectoration of large, branching bronchial casts. We describe a 39-year-woman with no prior lung disease who had episodic wheezing, severe dyspnea with expectoration of large and thick secretions, branching in appearance, which she described as resembling squid. A comprehensive evaluation revealed no specific cause and a diagnosis of idiopathic plastic bronchitis was made. In plastic bronchitis the bronchial casts may vary in size from small segmental casts of a bronchus to casts filling the airways of an entire lung. Plastic bronchitis can therefore present as an acute life-threatening emergency if mechanical obstruction of major airways occurs. The casts are differentiated into type I, inflammatory casts, or type II, acellular casts. The type I inflammatory casts are often associated with bronchial disease and often have an …