Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Medicina (Kaunas). 2021 Jan 8;57(1):50. doi: 10.3390/medicina57010050.
Foreign body (FB) aspiration occurs less frequently in adults than in children. Among the complications related to FB aspiration, pneumothorax is rarely reported in adults. Although the majority of FB aspiration cases can be diagnosed easily and accurately by using radiographs and bronchoscopy, some patients are misdiagnosed with endobronchial tumors. We describe a case of airway FB that mimicked an endobronchial tumor presenting with pneumothorax in an adult. A 77-year-old man was referred to our hospital due to pneumothorax and atelectasis of the right upper lobe caused by an endobronchial nodule. A chest tube was immediately inserted to decompress the pneumothorax. Chest computed tomography with contrast revealed an endobronchial nodule that was seen as contrast-enhanced. Flexible bronchoscopy was performed to biopsy the nodule. The bronchoscopy showed a yellow spherical nodule in the right upper lobar bronchus. Rat tooth forceps were used, because the lesion was too slippery to grasp with ellipsoid cup biopsy forceps. The whole nodule was extracted and was confirmed to be a FB, which was determined to be a green pea vegetable. After the procedure, the chest tube was removed, and the patient was discharged without any complications. This case highlights the importance of suspecting a FB as a cause of pneumothorax and presents the possibility of misdiagnosing an aspirated FB as an endobronchial tumor and selecting the appropriate instrument for removing an endobronchial FB.
异物（FB）吸入在成年人中比在儿童中少见。在与 FB 吸入相关的并发症中，气胸在成年人中很少见。尽管大多数 FB 吸入病例可以通过 X 线和支气管镜轻松准确地诊断，但一些患者被误诊为支气管内肿瘤。我们描述了一例气道 FB 病例，该病例表现为气胸，类似于成人的支气管内肿瘤。一名 77 岁男性因气胸和右上肺不张而被转诊至我院，原因是支气管内结节。立即插入胸腔引流管以减轻气胸。胸部 CT 增强扫描显示支气管内结节呈增强表现。进行了柔性支气管镜检查以对结节进行活检。支气管镜显示右上叶支气管中有一个黄色球形结节。由于病变太滑而无法用椭圆形杯活检钳夹住，因此使用了鼠齿钳。整个结节被提取出来，被确认为异物，被确定为一颗青豆蔬菜。手术后，胸腔引流管被移除，患者无任何并发症出院。本病例强调了怀疑 FB 是气胸原因的重要性，并提示可能将吸入性 FB 误诊为支气管内肿瘤，并选择合适的器械来取出支气管内 FB。
