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2008, Number 1

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Rev Inst Nal Enf Resp Mex 2008; 21 (1)

Unusual bronchoscopic images seen in a pulmonology unit from a general hospital

Septién-Stute L, Cicero-Sabido R, Navarro-Reynoso F, Pérez-Romo A

Language: Spanish
References: 17
Page: 38-44
PDF size: 151.25 Kb.


ABSTRACT

Introduction: Bronchoscopy is an indispensable tool for pneumologists and thoracic surgeons in the diagnostic and therapeutic management of bronchopulmonary diseases. Sometimes, unusual cases may be found, and because of their unfrequent nature they may pose a diagnostic and therapeutic challenge.
Objective: To present unusual cases that may pose a diagnostic and therapeutic challenge for the bronchoscopist, pulmonologist and thoracic surgeon.
Material and methods: We reviewed the database of bronchoscopic procedures variables and registered sex, age, diagnosis of admission, diagnosis of discharge, treatment, and evolution; cases were registered only once, if they had several admissions.
Results: During a five year period from January 2002 to September 2007, 4,234 bronchoscopies were performed at The Thoracic Endoscopy Department of the Alejandro Celis Pulmonology Unit of the Hospital General de México; from them we selected 7 unusual cases whose final diagnosis were: 1) Tracheobronchial amyloidosis with infection; 2) Bronchial rupture with stenosis secondary to blunt chest trauma; 3) Atypical bronchial carcinoid; 4) Organic foreign body with granuloma formation; 5) Primary adenocarcinoma of the tracheal wall; 6) Postintubation tracheal stenosis due to granulomas with tumoral aspect, and 7) Endobronchial metastases from osteogenic sarcoma. Two were treated by curative surgery and one of each by radiotherapy and chemotherapy, radiotherapy, laser and surgery, laser, and antibiotics plus corticosteroids.
Comment and conclusions: We selected 7 unusual cases presenting a diagnostic and therapeutic challenge. Bronchoscopy is an important and useful tool for the diagnosis and treatment of respiratory diseases. Bronchoscopists need formal training and experience to solve cases as those presented in this paper.


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