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The Clinical Respiratory Journal Sep 2023We aimed to explore the prognostic differences among T1-4N0-2M0 non-small cell lung cancer (NSCLC) patients with bronchus involvements and to validate the T category of...
BACKGROUND
We aimed to explore the prognostic differences among T1-4N0-2M0 non-small cell lung cancer (NSCLC) patients with bronchus involvements and to validate the T category of these patients in an external cohort.
METHODS
Univariable and multivariable Cox analysis was performed to determine the prognostic factors. Kaplan-Meier method with a log-rank test was used to compare overall survival differences between groups. Propensity score matching method was used to minimize the bias caused by the imbalanced covariates between groups.
RESULTS
A total of 169 390 eligible T1-4N0-2M0 NSCLC cases were included. There were 2354, 3367, 1638, 75, 87 585, 42 056, 19 246, and 13 069 cases in the group of superficial tumors of any size with invasive component limited to bronchial wall (T1-bronchus), tumors involving main stem bronchus ≥2 cm from carina (T2-main bronchus [≥2 cm]), tumors involving main stem bronchus <2 cm from carina (T2-main bronchus [<2 cm]), tumors with carina invasion (T4-carina), T1, T2, T3, and T4, respectively. Multivariable Cox analysis indicated that T1-bronchus patients had the best prognosis; T2-main bronchus (≥2 cm) and T2-main bronchus (<2 cm) patients had similar prognosis both in the entire cohort and in several subgroups. Survival curves showed that T1-bronchus and T1 patients had similar survival rates; the survivals of T2-main bronchus patients regardless of the distance from carina were comparable to those of T2 patients, and the survivals of T4-carina patients were also similar to those of T4 patients.
CONCLUSIONS
Our results validated and supported the current T category for the patients with bronchus involvements, which might provide certain reference value for the revisions of T category in the next version of the tumor-node-metastasis stage classification.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Bronchi; Prognosis; Survival Rate; Neoplasm Staging; Retrospective Studies
PubMed: 37545476
DOI: 10.1111/crj.13683 -
Hong Kong Medical Journal = Xianggang... Feb 2003
Topics: Bronchi; Humans; Infant; Male; Trachea
PubMed: 12547964
DOI: No ID Found -
Journal of Cardiothoracic Surgery Oct 2022Tracheal papillomatosis is a relatively rare condition with limited data on successful treatment modalities. To our knowledge, this is the first report to describe a...
BACKGROUND
Tracheal papillomatosis is a relatively rare condition with limited data on successful treatment modalities. To our knowledge, this is the first report to describe a papilloma arising from an accessory bronchus. Furthermore, this case report demonstrates successful treatment with clinical and patient-centered improvements after use of Spray Cryotherapy.
CASE PRESENTATION
A 71-year-old woman presented with one year history of recurrent fevers and intermittent hemoptysis. Imaging and video bronchoscopy revealed an obstructing papilloma of an accessory tracheal bronchus to the right upper lobe. She was treated with debridement followed by multiple cryotherapy treatments resulting in complete clinical and radiographic resolution of her post-obstructive pneumonia.
CONCLUSIONS
This case report not only supports existing literature on the use of cryotherapy for airway diseases but also presents a unique form of obstructing papilloma confined to an accessory bronchus, the only report of its kind based on extensive literature review.
Topics: Humans; Female; Aged; Bronchi; Bronchial Diseases; Trachea; Tracheal Diseases; Respiratory System Abnormalities; Bronchoscopy; Cryotherapy; Papilloma
PubMed: 36273154
DOI: 10.1186/s13019-022-01977-6 -
Respiratory Medicine 2020Bronchopulmonary dysplasia (BPD) is a condition of neonatal chronic lung disease due to disruption or dysregulation of pulmonary development. However, the...
Bronchopulmonary dysplasia (BPD) is a condition of neonatal chronic lung disease due to disruption or dysregulation of pulmonary development. However, the pathophysiology of BPD in the larger conducting airways is not yet fully understood. The objective of our study was to determine if the area of the central airways are altered in patients with a history of BPD. We hypothesized that compared to age- and sex-matched controls, BPD patients would have decreased area of the central conducting airways. Twenty-two BPD patients (n = 10 male, n = 12 female; median age = 10 [range:1-49] yrs) and n = 22 matched controls (n = 10 male, n = 12 female; median age = 10 [range:1-48] yrs) who had undergone a chest computed tomography (CT) scan were retrospectively identified. Measurement and analysis was performed using software that reconstructs the airways into 3D. Measurements of airway area were conducted at three points based on anatomic bifurcations for each of the following structures: trachea, left main bronchus, left upper lobe, left lower lobe, right main bronchus, intermediate bronchus, and right upper lobe. The luminal area for each airway was calculated based on the averages of the three measures. Airway luminal area was not different between BPD patients and matched controls for any of the measured airways (p > 0.05). Total lung volume detected in the CT scans was not different between BPD patients and matched controls (median [range]; 2775 [522-6215] vs 2969 [851-5612] cm, p > 0.05). Our results suggest the luminal areas of the large conducting airways in patients with BPD are not different from matched controls.
Topics: Adolescent; Adult; Bronchi; Bronchopulmonary Dysplasia; Child; Child, Preschool; Female; Humans; Imaging, Three-Dimensional; Infant; Lung; Lung Volume Measurements; Male; Middle Aged; Retrospective Studies; Tomography, X-Ray Computed; Trachea; Young Adult
PubMed: 32843156
DOI: 10.1016/j.rmed.2020.106071 -
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 -
Medicine Apr 2022Tracheal bronchus is an aberrant bronchus that arises directly from the carina of the trachea. It was rare, with only 0.1% to 2% on the right and 0.3% to 1% on the left...
RATIONALE
Tracheal bronchus is an aberrant bronchus that arises directly from the carina of the trachea. It was rare, with only 0.1% to 2% on the right and 0.3% to 1% on the left side of the lateral wall. Tracheal bronchus is usually asymptomatic and can be accidentally detected during bronchoscopy or computed tomography (CT).
PATIENT CONCERNS
A 62-year-old woman presented with recurrent cough and sputum for more than 1 month.
DIAGNOSIS
Bronchoscopy and three-dimensional-CT confirmed that the bronchial leiomyoma blocked the opening of the right apical segmental tracheal bronchus.
INTERVENTIONS
After 2 bronchoscopy treatments, the patient still complained of. cough and sputum. Finally, the patient underwent thoracotomy for a right apical segmentectomy and tracheoplasty.
OUTCOMES
The patient was safely discharged and no longer experienced cough. or sputum.
LESSONS
Surgery can reliably remove bronchial leiomyomas. When crossing. the tracheal bronchus, it is important to be cautious about the pulmonary. In such situations, bronchoscopy and three-dimensional-CT are beneficial for surgery.
Topics: Bronchi; Bronchoscopy; Cough; Female; Humans; Leiomyoma; Middle Aged; Trachea
PubMed: 35475803
DOI: 10.1097/MD.0000000000029181 -
The Journal of International Medical... Apr 2020This study was performed to analyze 22 cases of pneumonia (MPP) associated with bronchial casts (BCs) in children.
OBJECTIVE
This study was performed to analyze 22 cases of pneumonia (MPP) associated with bronchial casts (BCs) in children.
METHODS
We retrospectively reviewed all cases of MPP in children treated at our institution from November 2015 to December 2016. Demographic information, laboratory parameters, radiologic and fiberoptic bronchoscopy findings, treatment outcomes, and follow-up results were analyzed.
RESULTS
Among 161 patients with MPP, 22 had BCs and 139 had no BCs. All BCs occurred in a segmental or subsegmental bronchus and were removed by fiberoptic bronchoscopy. Patients with BCs had a longer duration of fever after admission and higher incidence of refractory MPP. Substantially more children with than without BCs had a high load in the bronchoalveolar lavage fluid. All patients with BCs but only 55.4% without BCs were given methylprednisolone in addition to the standard antibiotic treatment. A significantly higher proportion of children with than without BCs received oxygen therapy. After discharge, complete radiological resolution took significantly longer in children with than without BCs.
CONCLUSIONS
In children with MPP, prompt removal of BCs may be necessary to prevent BC propagation. MPP with BCs is more severe than that without BCs, and treatment and recovery are more difficult.
Topics: Bronchi; Child; Female; Humans; Image Processing, Computer-Assisted; Male; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Tomography, X-Ray Computed
PubMed: 32238033
DOI: 10.1177/0300060520911263 -
Journal of Anatomy Aug 2020A classical study has revealed the general growth of the bronchial tree and its variations up to Carnegie stage (CS) 19. In the present study, we extended the...
A classical study has revealed the general growth of the bronchial tree and its variations up to Carnegie stage (CS) 19. In the present study, we extended the morphological analysis CS by CS until the end of the embryonic period (CS23). A total of 48 samples between CS15 and CS23 belonging to the Kyoto Collection were used to acquire imaging data by performing phase-contrast X-ray computed tomography. Three-dimensionally reconstructed bronchial trees revealed the timeline of morphogenesis during the embryonic period. Structures of the trachea and lobar bronchus showed no individual difference during the analyzed stages. The right superior lobar bronchus was formed after the generation of both the right middle lobar bronchus and the left superior lobar bronchus. The speed of formation of the segmental bronchi, sub-segmental bronchi, and further generation seemed to vary among individual samples. The distribution of the end-branch generation among five lobes was significantly different. The median branching generation value in the right middle lobe was significantly low compared with that of the other four lobes, whereas that of the right inferior lobe was significantly larger than that of both the right and left superior lobes. Variations found between CS20 and CS23 were all described in the human adult lung, indicating that variation in the bronchial tree may well arise during the embryonic period and continue throughout life. The data provided may contribute to a better understanding of bronchial tree formation during the human embryonic period.
Topics: Bronchi; Humans; Image Processing, Computer-Assisted; Lung; Tomography, X-Ray Computed; Trachea
PubMed: 32285469
DOI: 10.1111/joa.13199 -
Medicine Oct 2022Benign scarring central airway stenosis can be managed by high-pressure balloon dilatation, laser, surgery and stent implantation. The stenosis may have a high...
INTRODUCTION
Benign scarring central airway stenosis can be managed by high-pressure balloon dilatation, laser, surgery and stent implantation. The stenosis may have a high recurrence rate that necessitates repeated treatment. Pirfenidone (PFD) has anti-fibrosis effects and has been used in a variety of fibrosis diseases. Animal experiments suggested that PFD can prevent tracheal stenosis.
PATIENT CONCERNS
Patients with scarring central airway stenosis usually have chest tightness, cough and dyspnea.
DIAGNOSIS
Computed tomography scanning showed stenosis of the trachea and/or bronchus. Bronchoscopy revealed occlusion or stenosis of the trachea or bronchus.
INTERVENTIONS
The use of PFD in combination with other interventional management was reported to treat 2 cases of tracheobronchial stenosis after injury in this study. In the combined use of PFD and interventional management, PFD could help to alleviate tracheobronchial stenosis, prolong the time interval of bronchoscopic interventional treatment, and reduce medical costs.
OUTCOMES
The stenosis in the trachea and/or bronchus is relieved and the patients do not have any relevant symptoms.
Topics: Humans; Constriction, Pathologic; Cicatrix; Tomography, X-Ray Computed; Bronchoscopy; Bronchi; Trachea; Stents
PubMed: 36316925
DOI: 10.1097/MD.0000000000031354 -
International Journal of Infectious... Sep 2007
Topics: Adult; Bronchi; Female; Hemoptysis; Humans; Trachea; Tuberculosis, Pulmonary
PubMed: 17331782
DOI: 10.1016/j.ijid.2006.11.002