Tao Xiaofen, Li Shuxian, Wu Lei, Chen Zhimin, Wang Yingshuo
Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China.
Department of Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China.
Respir Med Case Rep. 2023 Dec 8;46:101955. doi: 10.1016/j.rmcr.2023.101955. eCollection 2023.
Although airway foreign body aspiration (FBA) is a common occurrence in any age group, unrecognized and retained foreign bodies in lungs may result in severe complications, such as lung abscess or bronchiectasis. In rare cases, FBA may present with similar clinical features as many other diseases (e.g. asthma, tumor, pulmonary eosinophilia). Here, we report a rare case of missed FBA in a nine-year-old boy, whose chest CT scan was suggestive of a cavitary lesion in the left lower lobe mimicking congenital pulmonary airway malformation (CPAM). However, surprisingly, flexible bronchoscopy revealed a peanut lodged in the lateral basal segment of left lower lobe, which was subsequently retrieved by a forceps and avoided unnecessary surgical lobectomy. Therefore, FBA can mimic other disorders (e.g. CPAM), and a high index of suspicion and additional diagnostic techniques (e.g. flexible bronchoscopy) may be required to distinguish them. Additionally, FBA should be considered in the differential diagnosis of respiratory disorders in children even lack of aspiration history.
尽管气道异物误吸(FBA)在任何年龄组都很常见,但肺部未被识别和留存的异物可能会导致严重并发症,如肺脓肿或支气管扩张。在罕见情况下,FBA可能表现出与许多其他疾病(如哮喘、肿瘤、肺嗜酸性粒细胞增多症)相似的临床特征。在此,我们报告一例9岁男孩漏诊FBA的罕见病例,其胸部CT扫描提示左肺下叶有空洞性病变,类似先天性肺气道畸形(CPAM)。然而,令人惊讶的是,可弯曲支气管镜检查发现一枚花生仁嵌顿于左肺下叶外侧基底段,随后用钳子取出,避免了不必要的肺叶切除术。因此,FBA可能会模仿其他疾病(如CPAM),可能需要高度的怀疑指数和额外的诊断技术(如可弯曲支气管镜检查)来区分它们。此外,即使没有误吸病史,在儿童呼吸系统疾病的鉴别诊断中也应考虑FBA。