■支气管内异物抽吸在成人中并不常见,但这是一个危及生命的事件。由异物的慢性保留引起的复发性肺炎通常导致患者的初始医学表现。然而,淋巴浆细胞性支气管炎伴腺瘤性增生和鳞状上皮化生伴模仿肺肿瘤的肺叶支气管完全或部分阻塞在文献中很少见,这种特殊情况经常被误诊。
■我们报告了我们在诊断和管理两名老年复发性肺炎患者方面的经验,住院接受进一步检查。在这两个病人中,没有渴望的历史,在支气管镜检查和柔性冷冻探针再通期间检测到樱桃坑,被脓性分泌物包围,在第一种情况下完全闭塞右上叶,在第二例中,部分左下叶与持续性放线菌病有关,有局部炎症的迹象,在最初的支气管镜检查中模仿肺肿瘤的支气管腺瘤性增生。组织学显示淋巴浆细胞性支气管炎伴腺瘤样增生和鳞状上皮化生,因为异物的慢性保留。
■在高风险患者中出现未解决的慢性咳嗽并伴有复发性肺炎或持续性放线菌病的情况下,应考虑进行支气管镜检查。冷冻探针是治疗因慢性异物滞留引起的气道阻塞的安全可行的方法。此外,这里讨论了相关的发现,同时回顾了慢性异物保留和气道损伤的病理改变和治疗方式。
UNASSIGNED: Endobronchial foreign body aspiration is not common in adults, but it is a life-threatening event. Recurrent pneumonias by chronic retention of foreign body often lead to initial medical presentation of the patient. However, lymphoplasmacellular bronchitis with adenomatous hyperplasia and squamous epithelium metaplasia with complete or partial blockage of lobar bronchus mimicking lung tumor is rare in literature, and this particular condition is often misdiagnosed.
UNASSIGNED: we report our experience in the diagnostic and management of two elderly patients with recurrent pneumonia, admitted in hospital for further examination. In both patients, with no history of aspiration, the cherry pit was detected during bronchoscopy and recanalization with flexible cryoprobe, surrounded by purulent secretion, occluding completely the right upper lobe in the first case, and partially the left lower lobe associated with persistent
actinomycosis in the second case, with signs of local inflammation, bronchial adenomatous hyperplasia mimicking lung tumor at initial bronchoscopic examination. Histology showed a lymphoplasmacellullar bronchitis with adenomatous hyperplasia and squamous epithelium metaplasia because of chronic retention of foreign body.
UNASSIGNED: Bronchoscopy examination should be considered in cases where there is an unresolved chronic cough with recurrent pneumonia or persistent
actinomycosis in patients with high risk. Cryoprobe is a safe and feasible approach for treatment of airway obstructions due to chronic foreign body retention. Furthermore, relevant findings are discussed here, along with a review of the pathologic alterations and treatment modalities seen in chronic retention of foreign body and airway injury.