Bao Y C, Huang J F, Wang G F
Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2024 Sep 12;47(9):838-840. doi: 10.3760/cma.j.cn112147-20240425-00222.
Endobronchial chondroma is a rare benign bronchial tumor that originates from bronchial cartilage. As the disease progresses, it can obstruct the airway and cause clinical symptoms such as fever and cough. It is difficult to detect Endobronchial chondroma on a Chest X-ray, but chest CT can provide a more accurate diagnosis. Bronchoscopy is an effective means of diagnosing and treating this disease, and the diagnosis of the disease still depends on the pathological results of the biopsy. Currently, most cases of Endobronchial chondroma are treated by bronchoscopic resection or by surgery. Treatment should be based on the size, type and location of the tumor. As long as the diagnosis of Endobronchial chondroma is confirmed, it should be removed as soon as possible to avoid obstructive pneumonia, atelectasis or irreversible damage to lung tissue caused by tumor compression of the bronchi. This article reported a case of Endobronchial chondroma in a 19-year-old man whose main clinical manifestations were fever, cough and chest pain, with no apparent improvement after antibiotic treatment. Chest CT showed consolidation and atelectasis of the left upper lobe, and bronchial foreign body was considered by bronchoscopy in another hospital. However, the patient did not improve significantly after the foreign body was removed. After admission, the patient was considered to have left pulmonary obstructive pneumonia due to bronchial foreign body. A white tough foreign body was seen under bronchoscopy, which was too seriously adhered with the bronchus to be removed as a whole. After two bronchoscopic interventional treatments, the foreign body was successfully removed, and the bronchial lumen blocked by the foreign body was restored to patency. Pathology confirmed the diagnosis of endobronchial chondroma. The patient's symptoms improved and he was subsequently discharged. To date, the patient's symptoms of fever, cough, or chest pain have never recurred, and there is no obvious abnormality on repeat chest CT. This case provides an empirical reference for the diagnosis and treatment of endobronchial chondroma.
支气管内软骨瘤是一种罕见的起源于支气管软骨的良性支气管肿瘤。随着病情进展，它可阻塞气道并引发发热、咳嗽等临床症状。胸部X光片很难检测出支气管内软骨瘤，但胸部CT能提供更准确的诊断。支气管镜检查是诊断和治疗该疾病的有效手段，而疾病的诊断仍依赖于活检的病理结果。目前，大多数支气管内软骨瘤病例通过支气管镜切除或手术治疗。治疗应根据肿瘤的大小、类型和位置而定。一旦确诊支气管内软骨瘤，应尽快切除，以避免因肿瘤压迫支气管导致阻塞性肺炎、肺不张或对肺组织造成不可逆转的损害。本文报道了一例19岁男性支气管内软骨瘤病例，其主要临床表现为发热、咳嗽和胸痛，抗生素治疗后无明显改善。胸部CT显示左上叶实变和肺不张，外院支气管镜检查考虑为支气管异物。然而，异物取出后患者病情并未明显改善。入院后，患者因支气管异物被诊断为左肺阻塞性肺炎。支气管镜检查可见一个白色坚韧异物，与支气管粘连严重无法整体取出。经过两次支气管镜介入治疗，异物成功取出，被异物阻塞的支气管腔恢复通畅。病理确诊为支气管内软骨瘤。患者症状改善，随后出院。迄今为止，患者的发热、咳嗽或胸痛症状从未复发，复查胸部CT无明显异常。该病例为支气管内软骨瘤的诊断和治疗提供了经验参考。
