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previously visited CENTRAL BRONCHIAL OBSTRUCTION Random Case
Authored By: edward yi, Resident, David Grant Medical Center, Travis AFB, California, USA.
Patient: 63 year 3 month 3 week 5 day old male
History: 63 year old male smoker presents with complaint of coughing up blood.
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Fig. 1: Collapsed right middle lobe with right hilar mass and right paratracheal fullness.

Fig. 2: Right middle lobe mass obstructing the RML bronchus with resulting RML collapse.
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Findings: Chest radiographs demonstrate collapse of the right middle lobe.  Additionally, there are right hilar mass and right paratracheal fullness.

On the chest CT, there is a right middle lobe mass that compresses the RML bronchus with resulting RML collapse.
DDx: ENDOBRONCHIAL : carcinoid, small cell carcinoma, foreign body, broncholithiasis from histoplasma or TB, mucoepidermoid tumor, and hamartoma.

EXTRINSIC: Primary lung malignancy, metastases ( lung, breast, renal, thyroid, melanoma, etc.), lymphoma, fibrosing mediastinitis.
Diagnosis: Non-small cell lung cancer.
Discussion: The purpose of this case is to review the differential diagnosis for central bronchial ostruction. 

ENDOBRONCHIAL: foreign body, broncholithiasis most commonly from histoplasma or TB, carcinoid, small cell cancer, mucoepidermoid tunor, and hamartoma.

EXTRINSIC: metastses, primary lung cancer, lymphoma, and fibrosising mediastinitis.
References: McLoud, Theresa C. The Requisites: Thoracic Radiology. 1998.  pp: 374-382.

TE Hartman et al. CT of Bronchial and Brichiolar Diseases.  Radiographics. 1994; 14:991-1002.
Comments: post a comment
Small cell carcinome is not at all commonly association with endobronchial lesions, and should not be included on a short differential, even if that was the pathology in this case.--Andrew Swihart, 2010-01-07 09:24:38
Additional Details:

Case Number: 7333758Last Updated: 12-18-2006
Rating:

4 ratings
Anatomy: Chest   Pathology: Neoplasm
Modality: CT, Conventional RadiographAccess Level: Readable by all users
Keywords: neoplasm, lung, central bronchus, obstructionContained in: pkhsuvghtpe, Thorax
Case has been viewed 2305 times.

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