支气管镜治疗支气管软骨瘤1例

A case of bronchoscopic treatment for endobronchial chondroma

支气管软骨瘤是一种罕见的良性支气管肿瘤,随着病情进展,可阻塞肺叶引起相应的临床症状。本文报道1例19岁男性支气管软骨瘤患者,主要临床表现为发热伴胸痛,胸部CT可见左肺上叶实变及不张,外院行气管镜检查考虑左肺上叶支气管异物,入院后经两次支气管镜下介入治疗成功切除异物,术后病理证实为支气管软骨瘤。

Endobronchial chondroma is a rare benign bronchial tumor that originates from bronchial cartilage.As the disease progresses,it can obstruct the airway and cause clinical symptoms such as fever and cough.It is difficult to detect Endobronchial chondroma on a Chest X-ray,but chest CT can provide a more accurate diagnosis.Bronchoscopy is an effective means of diagnosing and treating this disease,and the diagnosis of the disease still depends on the pathological results of the biopsy.Currently,most cases of Endobronchial chondroma are treated by bronchoscopic resection or by surgery.Treatment should be based on the size,type and location of the tumor.As long as the diagnosis of Endobronchial chondroma is confirmed,it should be removed as soon as possible to avoid obstructive pneumonia,atelectasis or irreversible damage to lung tissue caused by tumor compression of the bronchi.This article reported a case of Endobronchial chondroma in a 19-year-old man whose main clinical manifestations were fever,cough and chest pain,with no apparent improvement after antibiotic treatment.Chest CT showed consolidation and atelectasis of the left upper lobe,and bronchial foreign body was considered by bronchoscopy in another hospital.However,the patient did not improve significantly after the foreign body was removed.After admission,the patient was considered to have left pulmonary obstructive pneumonia due to bronchial foreign body.A white tough foreign body was seen under bronchoscopy,which was too seriously adhered with the bronchus to be removed as a whole.After two bronchoscopic interventional treatments,the foreign body was successfully removed,and the bronchial lumen blocked by the foreign body was restored to patency.Pathology confirmed the diagnosis of endobronchial chondroma.The patient′s symptoms improved and he was subsequently discharged.To date,the patient′s symptoms of fever,cough,or chest pain have never recurred,and there is no obvious abnormality on repeat chest CT.This case provides an empirical reference for the diagnosis and treatment of endobronchial chondroma.