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Zhongguo Fei Ai Za Zhi = Chinese... Mar 2020Endotracheal and endobronchial metastases (EEM) is a rare manifestation in primary lung cancer. It has not yet been reported in Chinese literatures. The aim of this...
BACKGROUND
Endotracheal and endobronchial metastases (EEM) is a rare manifestation in primary lung cancer. It has not yet been reported in Chinese literatures. The aim of this study was to summarize and analyze the clinical feature of lung cancer with EEM.
METHODS
We retrospectively reviewed 6 patients who presented with EEM of lung cancer from Peking University Third Hospital from January 2015 to December 2018. With "endotracheal metastases, endobronchial metastases, lung cancer" as the keywords, 13 cases were retrieved from PubMed database until February 2020. The clinical, radiologic and bronchoscopic data were collected.
RESULTS
Six patients were selected from 967 patients with lung cancer, and all were diagnosed with lung cancer and EEM simultaneously. There were 4 cases of squamous cell carcinoma, 1 case of adenocarcinoma, and 1 case of small cell lung cancer. One patient had stage IIIb and 5 patients had stage IV. There were 5 cases of central lung cancer and 1 case of peripheral lung cancer. EEM on bronchoscope examination presented as endoluminal nodular or polypoid lesion in 5 patients, and abnormal white bulge in 1 patient. 5 cases metastasized to the contralateral bronchus, 1 case to the ipsilateral bronchus and 1 case to the trachea. The median overall survival was 7.5 months. Totally 13 cases of lung cancer with EEM were retrieved from PubMed database. 12 cases were diagnosed during the follow up after lung cancer resection. There were 8 cases of squamous cell carcinoma and 9 cases of central type. Endotracheal or endobronchial nodules showed in 10 cases and eccentric wall thickening in 2 cases were seen on chest computed tomography (CT), which corresponding to the nodular or polypoid lesion bronchoscopically. 5 cases metastasized to the contralateral bronchus, 10 cases to the trachea and 1 case to the ipsilateral bronchus.
CONCLUSIONS
EEM is a rare metastasis of lung cancer, which can occur at the initial diagnosis of lung cancer or after surgical resection. It is often seen in the patients of squamous cell carcinoma with central type in advanced stage. The prognosis is poor.
Topics: Aged; Aged, 80 and over; Bronchial Neoplasms; Female; Humans; Lung Neoplasms; Male; Middle Aged; Trachea; Tracheal Neoplasms
PubMed: 32209184
DOI: 10.3779/j.issn.1009-3419.2020.101.15 -
The Tohoku Journal of Experimental... Oct 2021Bronchial carcinoid is a rare malignant tumor that is categorized as a typical carcinoid or atypical carcinoid. Many institutions use flexible bronchoscopy for...
Bronchial carcinoid is a rare malignant tumor that is categorized as a typical carcinoid or atypical carcinoid. Many institutions use flexible bronchoscopy for diagnosis. However, due to the hemorrhagic nature of the tumor, the amount of specimen obtained is often small, making it difficult to obtain an accurate diagnosis. The use of rigid bronchoscopy may not only contribute to obtaining a diagnosis but also be beneficial in the treatment plan. The aim of this study was to evaluate the efficacy of rigid bronchoscopic interventions for the diagnosis and treatment of bronchial carcinoids. All patients with bronchial carcinoids who underwent rigid bronchoscopic intervention under general anesthesia at our institution between June 2006 and August 2018 were analyzed retrospectively. Eight patients [3 men and 5 women; median age, 71 years (range 45-82 years)] were eligible for the analysis. None of the cases had accurate subtyping preoperatively before intervention. In contrast, all cases were diagnosed as carcinoid with subtypes (5 patients had typical carcinoid and 3 had atypical carcinoid) following rigid bronchoscopic intervention. All respiratory symptoms improved immediately after the procedure. One instance of bleeding occurred, and was easily controlled by argon plasma coagulation and intraluminal administration of epinephrine under flexible and rigid bronchoscopy. Four patients (3 with typical carcinoid and 1 with atypical carcinoid) underwent radical surgery sequentially, and no recurrences were observed. We conclude that rigid bronchoscopic intervention is safe and effective for accurate diagnosis and improvement of respiratory symptoms in patients with bronchial carcinoids.
Topics: Aged; Aged, 80 and over; Bronchial Neoplasms; Bronchoscopy; Carcinoid Tumor; Endoscopy; Female; Humans; Male; Middle Aged; Retrospective Studies
PubMed: 34645769
DOI: 10.1620/tjem.255.105 -
Medicine Oct 2018Tracheobronchial benign tumors are uncommon; particularly, bronchial pleomorphic adenoma is one of the rarest benign tumors that develop in bronchus (only 7 reported... (Review)
Review
RATIONALE
Tracheobronchial benign tumors are uncommon; particularly, bronchial pleomorphic adenoma is one of the rarest benign tumors that develop in bronchus (only 7 reported cases, among which only 4 cases of pleomorphic adenoma were seen arising from right main bronchus).
PATIENT CONCERNS
In this report, a 38-year-old woman suffered from progressive shortness of breath for 5 years due to right main bronchial pleomorphic adenoma.
DIAGNOSES
The patient was diagnosed as right main bronchial pleomorphic adenoma based on chest computed tomography enhanced scan, bronchoscopy, and histological examination.
INTERVENTIONS
An electrosurgical snare was performed to resect the neoplasm and several APC were administered at the sites of the resection to provide hemostasis and further coagulate for the residual neoplasm.
OUTCOMES
The patient was free of symptoms and the lumen of right main bronchus was clear during the follow-up period for 10 months without any procedure-related complications.
LESSONS
Bronchial pleomorphic adenoma is extremely rare, however, we should take it into consideration if a patient suffered from shortness of breath without an exact cause.
Topics: Adenoma, Pleomorphic; Adult; Bronchi; Bronchial Neoplasms; Bronchoscopy; Electrosurgery; Female; Humans; Tomography, X-Ray Computed
PubMed: 30334948
DOI: 10.1097/MD.0000000000012648 -
Zhongguo Fei Ai Za Zhi = Chinese... Jul 2014Patients with tracheobronchial tumor are too frail for curative surgical treatment, and the original sites are unsuitable for radical resection. They always suffered...
BACKGROUND
Patients with tracheobronchial tumor are too frail for curative surgical treatment, and the original sites are unsuitable for radical resection. They always suffered from dyspnea, hymoptosis, obstructive pneumonia, and fever. Airway obstruction has a strong bad impact on the quality of life, and is the main cause of respiratory failure and death. An effective method of palliative is very important. We choose fibro-bronchoscopic cryosurgery for destruction of endobronchial tumors and analyze the outcomes.
METHODS
Clinical records of 126 cases who under went endobronchoscopic cryosurgery were reviewed retrospectively from August 2004 to February 2014. Techniques and survival outcomes were analyzed. The precise position and length of the cryosurgery was evaluated through three dimension chest computed tomography (CT) and reconstruction of trachea and bronchus. Local infiltration and general intravenous anesthesia are two options before surgical procedure. Endobronchial tumor was removed by combining two methods of "Cryo-Resecion" and "Cryo-Melt". Bronchoscopic examination was rechecked 2 weeks later to evaluate if it is necessary to redo the endobronchoscopic cryosurgery.
RESULTS
The symptoms of cough, short of breath, and hemoptysis were alleviated to different extend. The rate of dramatically improved and partial improved were 65.1% and 77.0% respectively. The mortality is 0.79%. Postoperative Complications included 2 cases of airway bleeding, 4 cases of bronchial stenosis, 2 cases of trachea burning injury, 2 cases of tracheomalacia, and 3 cases of atrium fibrillation. The median survival is 14 months, 1-, 2-, 3-yr survival rates were 58.6%, 24.2%, and 12.2% respectively, based on Kaplan-Meier estimates.
CONCLUSIONS
Endobronchial cryosurgery is an easy and effective minimally invasive choice for controlling and releasing the airway obstructive symptoms resulting from the trachea or bronchial tumors. Besides, the problem of difficult endotracheal intubation could be resolved after removing the tracheal tumor with the benefit of cryotreatment. Some patients could get the chance for further treatment or radical resection. Therefore, the patients' quality of life could be improved and the lifetime could be prolonged.
Topics: Adult; Aged; Aged, 80 and over; Bronchial Neoplasms; Bronchoscopy; Cryosurgery; Female; Humans; Male; Middle Aged; Retrospective Studies; Survival Rate; Young Adult
PubMed: 25034584
DOI: 10.3779/j.issn.1009-3419.2014.07.08 -
Chinese Medical Journal Oct 2017Tracheobronchial mucoepidermoid carcinoma (MEC) is a rare airway tumor in adults for which surgery is considered a first-line treatment. However, some patients already...
BACKGROUND
Tracheobronchial mucoepidermoid carcinoma (MEC) is a rare airway tumor in adults for which surgery is considered a first-line treatment. However, some patients already lost the best opportunity of a surgical intervention when diagnoses are confirmed, and surgery causes considerable trauma resulting in partial loss of pulmonary function. Moreover, the tumor is resistant to radiotherapy and chemotherapy. These factors make the treatment of tracheobronchial MEC challenging. This study aimed to evaluate the safety and efficacy of interventional bronchoscopic therapy in adult patients with tracheobronchial MEC.
METHODS
We retrospectively analyzed the clinical manifestations, bronchoscopic interventions, complications, and outcomes of 11 adult patients with tracheobronchial MEC. Paired t-test was used to analyze the parameters of the American Thoracic Society Dyspnea Index and the Karnofsky Score before and after the first interventional bronchoscopic therapy.
RESULTS
All tumors occurred in the main bronchus and were easily visualized by bronchoscopy. After interventional bronchoscopic therapy, the symptoms of all patients showed significant improvement. The American Thoracic Society Dyspnea Index decreased from 1.91 ± 1.22 to 0.27 ± 0.47 (t = 6.708, P < 0.001) and the Karnofsky Score increased from 78.18 ± 16.62 to 95.46 ± 8.20 (t = -5.190, P < 0.001). Bronchoscopic intervention did not result in serious complications or mortality. During the follow-up period between 3 and 96 months after the first therapy, the following results were noted: (1) among the eight patients with low-grade tracheobronchial MEC, only one patient had a relapse and agreed to surgical treatment; (2) among the three patients with high-grade tracheobronchial MEC, one patient required repeated bronchoscopic interventions, one patient died of pulmonary infection, and one patient died of systemic failure owing to tumor metastasis.
CONCLUSIONS
Interventional bronchoscopic therapy, as an alternative treatment, shows promise in some adult patients with low-grade tracheobronchial MEC confined to the bronchus. However, for adult patients with high-grade tracheobronchial MEC, early diagnosis and surgical treatment are still strongly recommended.
Topics: Adult; Aged; Bronchial Neoplasms; Bronchoscopy; Carcinoma, Mucoepidermoid; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Retrospective Studies; Tomography, X-Ray Computed; Tracheal Neoplasms; Young Adult
PubMed: 29052567
DOI: 10.4103/0366-6999.216417 -
European Respiratory Review : An... Mar 2021Carcinoid tumours are rare neuroendocrine neoplasms that mostly occur in younger adults with low tendencies to metastasise. Based on their histological characteristics,... (Review)
Review
Carcinoid tumours are rare neuroendocrine neoplasms that mostly occur in younger adults with low tendencies to metastasise. Based on their histological characteristics, they are divided into typical and atypical subtypes. The most common presenting symptoms are due to central airway obstruction. The first step in the diagnostic assessment should be a computed tomography (CT) scan, as it provides information both for local tumour extent and lymph node involvement. Bronchoscopy is the main tool for histological confirmation, evaluation of bronchial wall invasion and removal of endobronchial manifestation with subsequent resolution of atelectasis. Endobronchial ultrasound may be necessary to rule out lymph node metastasis. Somatostatin receptor scintigraphy in combination with CT can rule out further metastatic disease.Surgical resection using parenchyma-sparing techniques remains the gold standard for treatment. For selected patients, endobronchial therapy could be an alternative for minimal invasiveness. Long-term follow-up is suggested due to the high likelihood of recurrence.Here, we describe our clinical experience in a 35-year-old male patient who originally presented with haemoptysis and a central polypoid tumour in the left main bronchus revealed by a CT scan. The histological characteristics were indicative of a typical carcinoid. The patient was treated using an endobronchial approach only. No complications and no recurrences have been observed in a follow-up of 2 years.
Topics: Adult; Bronchi; Bronchial Neoplasms; Bronchoscopy; Carcinoid Tumor; Humans; Male; Pneumonectomy
PubMed: 33408086
DOI: 10.1183/16000617.0115-2020 -
British Medical Journal (Clinical... Jan 1981
Topics: Adenoma; Bronchial Neoplasms; Carcinoid Tumor; Carcinoma, Adenoid Cystic; Female; Humans; Male
PubMed: 6257323
DOI: No ID Found -
The Pan African Medical Journal 2017The endobronchial localization of Hodgkin's disease is a rare entity which is often confused with endobronchial tuberculosis in our setting. We report the case of a 16...
The endobronchial localization of Hodgkin's disease is a rare entity which is often confused with endobronchial tuberculosis in our setting. We report the case of a 16 years old female who presented with 6 months history of dry cough, hemoptysis, dyspnea, dysphagia and dysphonia. The chest radiography showed a mediastinal and pulmonary opacity. The chest CT scan found enlarged mediastinal lymph nodes. The bronchial biopsy and peripheral lymph node biopsy confirmed Hodgkin's disease with endobronchial localization. The patient received chemotherapy (ABVD protocol) and radiotherapy with a favorable follow up.
Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Biopsy; Bleomycin; Bronchial Neoplasms; Dacarbazine; Doxorubicin; Female; Follow-Up Studies; Hodgkin Disease; Humans; Lymph Nodes; Tomography, X-Ray Computed; Vinblastine
PubMed: 29138655
DOI: 10.11604/pamj.2017.28.9.11315 -
The Pan African Medical Journal 2020Bronchopulmonary cancer is the leading cause of death in men and the second in women. Some endoscopic or radiological features may guide histological diagnosis and thus...
Bronchopulmonary cancer is the leading cause of death in men and the second in women. Some endoscopic or radiological features may guide histological diagnosis and thus facilitate therapeutic management. We here report the case of a 54-year old man, with a history of smoking and recent coronary stent implantation, presenting with haemoptysis and worsening of dyspnea which had evolved over the last month. Chest x-ray showed left pulmonary hemifield lucency with signs of retraction. Bronchial fibroscopy objectified raspberry bud formation spontaneously bleeding, originating from the left main bronchus and suggesting carcinoid tumor. Chest computed tomography (CT) scan showed poorly enhanced endoluminal tissue process at the level of the left main bronchus, located four cm from the carina and complicated with atelectasis. Diagnostic and therapeutic surgery helped to adjust to a diagnosis of endobronchial amartocondroma.
Topics: Bronchial Neoplasms; Bronchoscopy; Carcinoid Tumor; Dyspnea; Fiber Optic Technology; Hamartoma; Hemoptysis; Humans; Male; Middle Aged; Pulmonary Atelectasis; Tomography, X-Ray Computed
PubMed: 33505570
DOI: 10.11604/pamj.2020.37.201.22896 -
Canadian Respiratory Journal 2023Endobronchial lipoma (EL) is a rare benign tumor characterized by tracheobronchial smooth-surfaced mass, often resulting in bronchial obstruction without standard...
Endobronchial lipoma (EL) is a rare benign tumor characterized by tracheobronchial smooth-surfaced mass, often resulting in bronchial obstruction without standard guidelines for management. This study seeks to clarify the clinical features and interventions of EL, aiming to improve its diagnosis and outcomes. A retrospective review was conducted on 28516 outpatients treated between January 2015 and December 2019 at the Department of Respiratory and Critical Care Medicine of the Second Affiliated Hospital of Air Force Medical University to collect patients diagnosed with EL. Their clinical, bronchoscopic, chest imaging, and histopathological features along with management were analyzed. Among the patients reviewed, nine were histopathologically diagnosed with EL, comprising seven males and two females. All EL patients exhibited noticeable symptoms, including cough (in eight patients), dyspnea (in six patients), fever (in three patients), expectoration (in two patients), chest pain (in two patients), hemoptysis (in one patient), and fatigue (in one patient). Chest CT abnormalities included endobronchial mass (in four patients), inflammatory exudation (in three patients), atelectasis (in three patients), and infiltration or consolidation (in two patients). In three patients, imaging showed fat density, directly leading to the diagnosis of EL. The EL lesions were distributed with six in the right lung and three in the left lung, all located within the first three subdivisions of the tracheobronchial tree. Treatment approaches varied, with one patient undergoing combined bronchoscopic resection and surgery. The remaining patients received bronchoscopic intervention such as electrosurgical snare resection, argon plasma coagulation (APC), cryotherapy, and holmium laser. Histopathological analysis confirmed the EL diagnosis. Finally, the mass removal restored bronchus patency. Taken together, EL symptoms lack specificity, necessitating reliance on histopathology for EL accurate diagnosis. Bronchoscopic interventions emerge as the preferred option for EL management, surpassing surgical approaches.
Topics: Male; Female; Humans; Constriction, Pathologic; Bronchial Diseases; Bronchi; Lung Neoplasms; Lipoma; Bronchoscopy; Bronchial Neoplasms
PubMed: 38170103
DOI: 10.1155/2023/2799436