title: Foreign body aspiration diagnosed by microscopy.
abstract: We report a rare case of foreign body aspiration diagnosed by microscopic analysis of a sample of the foreign body. A 50-year-old man presented with a 5-month history of 40 pound weight loss and a nonresolving right lower lobe pneumonia. Medical history, radiographic studies, direct visualization of the foreign body by flexible fiberoptic bronchoscopy, and gross examination of a sample of the foreign body retrieved by a forceps biopsy catheter failed to yield the diagnosis. Moderate bleeding associated with the bronchoscopic "biopsy" procedure contributed to a preliminary misdiagnosis of endobronchial tumor. Microscopic analysis of the "biopsy" specimen demonstrated vegetable matter. The patient underwent rigid bronchoscopy and a peanut was retrieved from the bronchus intermedius. He was maintained on antibiotics for an additional 8 weeks and had complete clinical and radiographic recovery. The epidemiology, presentation, and management strategies of foreign body aspiration in the adult are briefly reviewed.
authors.affiliation: Medical Service, Veterans Affairs Palo Alto Health Care System, Stanford University, School of Medicine, California 94304, USA. kuschner@stanford.edu
authors.forename: W G
authors.initials: WG
authors.lastname: Kuschner
authors.forename: P S
authors.initials: PS
authors.lastname: Sarinas
authors.forename: R
authors.initials: R
authors.lastname: Chitkara
mesh_terms: D010367:Arachis; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000209:etiology*; D014057:Tomography, X-Ray Computed