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Abstract

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Article in Japanese

Case Report

A case of inflammatory granuloma secondary to a foreign body (Cryptomeria) mimicking a bronchial tumor

Tomokazu Furukawa1)2)  Hiroko Nogami2)  Kenji Hirayama2)  Hiroshi Aso2)  Nobuhiro Kamikawaji2)  Terufumi Shimoda2)  Shunsuke Shoji2)  Sankei Nishima2) 

1)Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University 2)National Hospital Organization, Fukuoka National Hospital

ABSTRACT

This report documents a case of inflammatory granuloma overcoming secondary to a foreign body (Cryptomeria) mimicking a bronchial tumor. A 45-year-old man was referred to the hospital because of hemoptysis and a chronic cough. He had had a chronic cough before visiting the hospital, but had left it untreated for months. A computed tomography (CT) scan showed bronchiectasis in the right lower lobe with evidence of mediastinal lymphadenopathy. Fiberoptic bronchoscopic examinations revealed a tumor with an uneven surface at the orifice of the right B10b+c bronchus. The cytological findings of the bronchial tumor showed no malignancy but a predominance of neutrophils. Antibiotics were administered intravenously because of a suspected respiratory infection. After treatment, the abnormal shadows on the chest CT improved. Fiberoptic bronchoscopic examinations showed the bronchial tumor to have disappeared, and a bronchial foreign body was found lodged in the right. B10b+c bronchus and it was removed. Pathological examinations and a detailed history revealed that the patient had aspirated a foreign body (Cryptomeria). The tumor was thought to be an inflammatory granuloma secondary to the aspiration of the foreign body. This case highlights the need to search aggressively for foreign bodies in case of clinical symptoms, such as chronic cough, hemoptysis, or findings such as respiratory infection, and bronchial occlusion.

KEYWORDS

Bronchial foreign body  Hemoptysis  Bronchial tumor  Inflammatory granuloma  Cryptomeria 

Received 平成19年11月5日

JJRS, 46(12): 987-991, 2008

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