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一名中年男性,有 15 年煤炭使用史,其气管内有一罕见异物:病例报告。

An unusual tracheal foreign body in a middle-aged male with a 15-year history of coal use: a case report.

机构信息

Department of Radiology, The People's Hospital of Leshan, Leshan City, 614000, People's Republic of China.

Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, 401120, People's Republic of China.

出版信息

BMC Med Imaging. 2021 Feb 23;21(1):35. doi: 10.1186/s12880-021-00561-z.

Abstract

BACKGROUND

Long-term exposure to coal dust causes respiratory disease. In chest computer tomography (CT), pulmonary nodules, pulmonary interstitial fibrosis and emphysema manifest themselves. However, tracheal foreign bodies caused by coal dust are rarely reported. In this study, we report a special case of a tracheal coal foreign body, in which the patient has neither a history of coal work nor foreign body inhalation.

CASE PRESENTATION

A 49-year-old man was diagnosed with chronic obstructive pulmonary disease (COPD) due to chronic cough and exertional dyspnoea. His symptoms gradually worsened despite treatment for COPD. Chest radiograph and CT images showed an irregular high-density nodule inserting fromthe trachea into the right thyroid at approximately the level of the 7th cervical vertebra. Fiberoptic bronchoscopy revealed that the tracheal lumen was mostly blocked. After the surgery, the energy spectrum CT quantitative analysis showed that the foreign body was likely that of a bituminous coal specimen.

CONCLUSIONS

For cases in which a foreign body in the airway is highly suspected, early fiberoptic bronchoscopy and radiographic examinations should be performed as soon as possible to avoid misdiagnosis and ensure timely treatment.

摘要

背景

长期接触煤尘可导致肺部疾病。在胸部计算机断层扫描(CT)中,肺部结节、肺间质纤维化和肺气肿表现明显。然而,由煤尘引起的气管异物则很少见。本研究报告了一例特殊的气管煤尘异物,该患者既无煤工尘肺病史,也无异物吸入史。

病例介绍

一名 49 岁男性因慢性咳嗽和劳力性呼吸困难被诊断为慢性阻塞性肺疾病(COPD)。尽管针对 COPD 进行了治疗,但他的症状仍逐渐恶化。胸部 X 线和 CT 图像显示,在第 7 颈椎水平,一个不规则的高密度结节从气管插入右侧甲状腺。纤维支气管镜检查显示气管腔大部分被阻塞。手术后,能谱 CT 定量分析显示异物可能是烟煤标本。

结论

对于高度怀疑气道内有异物的病例,应尽早进行纤维支气管镜和影像学检查,以避免误诊,确保及时治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab1b/7901105/c9b656172160/12880_2021_561_Fig1_HTML.jpg

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