Lisznyai Eric, Hutchings Hollis, Debiane Labib, Okereke Ikenna
Department of Surgery, Henry Ford Health, 2799 West Grand Boulevard, Detroit, MI 48202, United States of America.
Division of Interventional Pulmonology, Henry Ford Health, 2799 West Grand Boulevard, Detroit, MI 48202, United States of America.
Int J Surg Case Rep. 2024 Sep;122:110167. doi: 10.1016/j.ijscr.2024.110167. Epub 2024 Aug 13.
Central airway tumors can occasionally be misdiagnosed as a chronic disease. We present a case of a central airway carcinoid tumor that was mistaken as chronic asthma for many years.
A 29-year-old male bodybuilder presented to our emergency department with shortness of breath and hemoptysis. He was an avid bodybuilder who participated in competitions. He had been diagnosed with asthma for years and used an albuterol inhaler chronically. Computed tomography of the chest showed diffuse opacification of the left hemithorax, multiple air-fluid levels and a 4-cm mass of the proximal left mainstem bronchus with intraluminal calcifications. Bronchoscopy demonstrated a large endobronchial mass, and biopsy was positive for typical carcinoid tumor. Stabilization was achieved with rigid bronchoscopy and partial endobronchial debridement of the tumor to allow some patency to the left lung. After stabilization, he subsequently underwent left pneumonectomy. He recovered well and was discharged home on postoperative day 2. On surveillance 2.5 years after pneumonectomy, he has resumed bodybuilding and has no evidence of recurrent disease.
Proximal airway tumors can mimic asthma. Careful management can achieve successful results even in very complex cases. There should be an increased level of suspicion for other diagnoses, especially in young and healthy individuals with asthma that is refractory to medical treatment.
Proximal airway tumors can mimic chronic diseases such as asthma. Other diagnoses should be considered, especially in young and health individuals with asthma symptoms that do not respond to conventional therapies.
中央气道肿瘤偶尔会被误诊为慢性疾病。我们报告一例中央气道类癌肿瘤,多年来一直被误诊为慢性哮喘。
一名29岁的男性健美运动员因呼吸急促和咯血就诊于我院急诊科。他是一名热衷于参加比赛的健美运动员。他多年来一直被诊断为哮喘,长期使用沙丁胺醇吸入器。胸部计算机断层扫描显示左半胸弥漫性模糊、多个气液平面以及左主支气管近端有一个4厘米的肿块,肿块内有钙化。支气管镜检查发现一个大的支气管内肿块,活检显示典型类癌肿瘤阳性。通过硬质支气管镜检查和对肿瘤进行部分支气管内清创,使左肺有一定通畅度,病情得以稳定。病情稳定后,他随后接受了左肺切除术。他恢复良好,术后第2天出院。在肺切除术后2.5年的随访中,他已恢复健美运动,且无疾病复发迹象。
近端气道肿瘤可酷似哮喘。即使在非常复杂的病例中,谨慎处理也能取得成功。对于其他诊断应提高怀疑程度,尤其是在年轻健康的哮喘患者中,其哮喘对药物治疗无效时。
近端气道肿瘤可酷似哮喘等慢性疾病。应考虑其他诊断,尤其是在有哮喘症状但对传统治疗无反应的年轻健康个体中。