[Bronchoesophageal fistula in a patient with untreated malignant lymphoma].
Bronchoesophageal fistulae associated with lymphomas are generally associated with chemo-radiotherapy. We report here an unusual case of lymphoma with a therapy-unrelated bronchoesophageal fistula. Previously, only 10 similar cases have been reported. A 70-year-old male was diagnosed as having gastric diffuse large B-cell lymphoma in May 1998. In January 1999, he noted a cough after eating and drinking. Because of the presence of a febrile temperature, productive cough and dyspnea, he was referred to our hospital and diagnosed as having aspiration pneumonia. Antibiotics did not improve his symptoms. When tracheal intubation was performed with bronchoscopy, a bronchoesophageal fistula was revealed. Malignant lymphoma cells were found around the fistula in the biopsy specimen. The patient died of pneumonia after treatment with airway stenting and chemotherapy. Induction of necrosis by chemotherapy or low blood flow with stenting and dopamine probably caused enlargement of the fistula.
Uenogawa
Kumi
K
Department of Hematology and Rheumatology, Nihon University School of Medicine.
Hatta
Yoshihiro
Y
Oshiro
Shu
S
Hagikura
Kazuhiro
K
Takahashi
Noriaki
N
Kura
Yoshimasa
Y
Yamazaki
Tetsuo
T
Akashiba
Tsuneto
T
Sawada
Umihiko
U
Horie
Takashi
T
D000368:Aged; D001983:Bronchial Fistula / Q000209:etiology* / Q000628:therapy; D004937:Esophageal Fistula / Q000209:etiology* / Q000628:therapy; D017809:Fatal Outcome; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications*; D008297:Male; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000628:therapy; D015607:Stents / Q000009:adverse effects