[Inflammatory pseudopapilloma after recurring aspiration of fruit stones as rare differential diagnosis of bronchogenic cancer].
We present the case of a 51-year old man with drug-resistant pneumonia in the upper right lobe, weight loss and a 50-pack year history of cigarette smoking who underwent bronchoscopy. By clinical and radiological findings bronchogenic cancer was assumed. Fiberbronchoscopy showed an exophytic tumor-like mass obliterating the right upper lobe. Biopsies revealed an epithelial pseudopapillomatous tumor with multiple mucosal dysplasia and metaplasia. A second bronchoscopy in order to remove the lesion revealed a foreign body embedded in the tissue which could be removed easily. The foreign body proved to be a cherry stone, after its removal pneumonia resolved completely. In the same patient this lesion was recurrent one year later after aspiration of a grape seed. We present this case to emphasize the relationship between foreign body aspiration and inflammatory pseudopapilloma as a sequela of the inflammatory insult provoked by foreign bodies. Bronchoscopy is mandatory and may obviate misdiagnosis and thoracotomy. The use of inhaled and systemic steroids can be used to facilitate successful endoscopic extraction.
Berufsgenossenschaftliche Kliniken Bergmannsheil Bochum, Klinikum der Ruhr-Universität Bochum, Medizinische Klinik und Poliklinik, Abteilung für Pneumologie, Allergologie und Schlafmedizin,. Joerg.walther@ruhr-uni-bochum.de
J W
JW
Walther
J
J
Kollmeier
J
J
De Zeeuw
M
M
Orth
A
A
Wiethege
K M
KM
Müller
G
G
Schultze-Werninghaus
K
K
Rasche
D002283:Carcinoma, Bronchogenic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005547:Foreign Bodies / Q000601:surgery*; D005638:Fruit; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010212:Papilloma / Q000175:diagnosis*; D012008:Recurrence; D012639:Seeds; D014057:Tomography, X-Ray Computed