Santra Avradip, Dutta Pravati, Pothal Sudarsan, Manjhi Rekha
Department of Pulmonary Medicine, Veer Surendra Sai Medical College and Hospital, P.O. +P.S. Burla, Odisha, India, Pin-768017.
Malays J Med Sci. 2013 May;20(3):78-82.
A 59-year-old male smoker presented with persistent wheezing and occasional coughing that had been ongoing for two years and had been unsuccessfully treated with an inhalational β2 agonist, an anticholinergic and an inhalational steroid in the last year. On clinical examination, a left-sided wheeze was detected. The initial chest X-ray was normal. A computed tomography (CT) scan of thorax demonstrated a mass lesion in the left main bronchus. On subsequent bronchoscopy, an endobronchial polypoid mass was detected in the left main bronchus, completely occluding the bronchial lumen. A biopsy taken from the mass revealed features of bronchial carcinoid. Bronchial carcinoid can present uncommonly with wheezes, resulting in misdiagnosis as bronchial asthma or chronic obstructive pulmonary disease (COPD). If an asthma or COPD patient does not respond to conventional therapy, a CT scan and subsequent bronchoscopy is warranted.
一名59岁男性吸烟者，持续喘息和偶尔咳嗽两年，去年使用吸入性β2激动剂、抗胆碱能药物和吸入性类固醇治疗无效。临床检查发现左侧喘息。最初的胸部X光检查正常。胸部计算机断层扫描（CT）显示左主支气管有肿块。随后的支气管镜检查发现左主支气管内有一个支气管内息肉样肿块，完全阻塞了支气管腔。肿块活检显示为支气管类癌特征。支气管类癌很少以喘息为表现，易误诊为支气管哮喘或慢性阻塞性肺疾病（COPD）。如果哮喘或COPD患者对常规治疗无反应，有必要进行CT扫描及后续支气管镜检查。
