Aoki Hikaru, Aikawa Masaki, Kushima Yoshitomo, Watanabe Jiro, Shima Toshiyuki, Kameyama Yoju
Department of Thoracic Surgery Ashikaga Red Cross Hospital Ashikaga Japan.
Department of Medicine Ashikaga Red Cross Hospital Ashikaga Japan.
Respirol Case Rep. 2025 Jun 22;13(6):e70251. doi: 10.1002/rcr2.70251. eCollection 2025 Jun.
Bronchial diverticulum (BD) is a rare airway abnormality that rarely enlarges significantly or becomes infected. We report a case of an 80-year-old male with a 15-year history of asymptomatic BD that gradually increased in size and eventually developed into an abscess. Chest computed tomography revealed a cystic lesion adjacent to the left main bronchus with internal fluid and surrounding inflammation. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) enabled safe aspiration and identification of alpha-hemolytic despite the absence of a visible bronchial opening. The infection was successfully managed with antibiotics alone, thereby avoiding surgical intervention. This case highlights the potential for long-term asymptomatic BD to develop infection and demonstrates the diagnostic utility of EBUS-TBNA for lesions adjacent to vital structures. However, further studies are needed to clarify infection risk factors and optimal management strategies for BD.
支气管憩室（BD）是一种罕见的气道异常，很少会显著增大或发生感染。我们报告一例80岁男性，有无症状BD病史15年，其大小逐渐增加，最终发展为脓肿。胸部计算机断层扫描显示左主支气管旁有一个囊性病变，内部有液体且周围有炎症。尽管没有可见的支气管开口，但支气管内超声引导下经支气管针吸活检（EBUS-TBNA）实现了安全抽吸并鉴定出α溶血性菌。仅用抗生素就成功控制了感染，从而避免了手术干预。该病例突出了长期无症状BD发生感染的可能性，并证明了EBUS-TBNA对重要结构附近病变的诊断效用。然而，需要进一步研究以阐明BD的感染危险因素和最佳管理策略。
