Foreign body aspiration mimicking tuberculosis or lung tumour – case report

Background: Bronchial foreign body aspiration is rare problem in adults. However, it is not an uncommon problem, particularly in children, the elderly and patients with neurological impairment. Aspiration of foreign bodies into the airways can remain undetected for months to years.
Case Report: We described here a case of 78-years-old nonsmoker male, who was hospitalized in our Department because of radiological and clinical suspicion of pulmonary tuberculosis. The patient underwent bronchoscopy and computed tomography. On flexible bronchoscopy, a tumor with necrosis occluded right upper lobe bronchus was identified. A CT scan of the thorax showed cavitations and fi brous changes in the right upper lobe as well as lymphadenopathy with right upper bronchus compression. However, the pulmonary tuberculosis as well as lung cancer were not confirmed in bacteriological and histopathological examination. A second fibreoptic bronchoscopy was done to evaluate the aetiology of lung abnormality. This showed the foreign body and allowed the successful
removal of chicken bone. The patients recovered with no residual respiratory symptoms over one year.
Conclusions: The foreign body may be present in the bronchi despite complete unawareness of the patient about aspiration and should be considered in the diagnosis of clinical symptoms and radiological lesions of unclear aetiology. In some cases despite the radiological features of tuberculosis, more intensive examinations should be administrated which could confirm diagnosis. In such cases bronchoscopies, sometimes repeated, are necessary.

Keywords: foreign body aspiration, lung tumour, Tuberculosis