PDF(Pubmed)
Abstract：
Pseudobronchial crista-like change is an unusual type of inflammatory granulation tissue hyperplasia in the endobronchial membrane caused by chronic retention of bronchial foreign bodies. Here, we report a case of pseudobronchial crista-like change in a 4-year-old boy who required admission for intermittent cough for >10 days and wheezing for 2 days. The main manifestation was persistent and non-healing lobar pneumonia. Initial electronic bronchoscopy showed cristae at the distal left main bronchus, which was misdiagnosed as bronchial opening stenosis. Repeat electronic bronchoscopy was performed after standard antibiotic treatment proved ineffective. Foreign bodies were observed at the opening of the basal branch of the left lower lobe. The left main bronchial cristae were clamped. The cristae appeared to be a pseudobronchial crista-like change caused by long-term retention of bronchial foreign bodies. After CT-confirmation of no abnormal blood supply at the cristae, the bronchial foreign bodies were removed, and the distal cristae of the left main bronchus were cut-off by laser, followed by balloon dilatation. To our knowledge, no similar cases have been reported so far in our review of domestic and foreign literature. Insufficient clinical understanding of Pseudobronchial Crista-like Change increase the risk of misdiagnosis and missed diagnosis. Detailed exploration and careful identification under bronchoscopy are helpful for the timely diagnosis and treatment of Pseudobronchial Crista-like Change.
摘要：
假支气管crista样改变是支气管异物慢性滞留引起的支气管内膜炎性肉芽组织增生的一种不寻常类型。这里,我们报告了一例4岁男孩的假支气管crista样改变，该男孩因间歇性咳嗽>10天和喘息2天需要入院。主要表现为持续性和不愈合的大叶性肺炎。最初的电子支气管镜检查显示左主支气管远端有cr，误诊为支气管开口狭窄。在标准抗生素治疗无效后进行重复电子支气管镜检查。在左下叶的基底支的开口处观察到异物。左主支气管cr被夹住。cr似乎是由于长期保留支气管异物而引起的假支气管cr状变化。在CT确认在cr处没有异常的血液供应后，切除了支气管异物,左主支气管的远端cr被激光切断，接着是气球扩张。据我们所知,到目前为止，我们在国内外文献综述中没有类似病例的报道。临床对假支气管Crista样改变的认识不足会增加误诊和漏诊的风险。在支气管镜下进行详细的探查和仔细的识别有助于及时诊断和治疗假支气管Crista样改变。
