Unusual clinical course, Challenging differential diagnosis, Unusual setting of medical care
Tsuyoshi Oguma, Hiroto Takiguchi, Kyoko Niimi, Hiromi Tomomatsu, Katsuyoshi Tomomatsu, Naoki Hayama, Takuya Aoki, Tetsuya Urano, Natsuko Nakano, Go Ogura, Tomoki Nakagawa, Ryota Masuda, Masayuki Iwazaki, Tadashi Abe, Koichiro Asano
(Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan)
Am J Case Rep 2014; 15:388-392
Post-obstructive pneumonia occurs in the presence of airway obstruction, usually caused by lung cancer. However, there are cases of bronchial obstruction due to benign origin such as foreign bodies and benign endobronchial tumors, which are often misdiagnosed.
Case Report: A 66-year-old man was referred to our hospital due to high fever with abnormal shadow in the right lung. Chest computed tomography after a course of antibiotic treatment showed an intra-bronchial tumor obstructing the right upper bronchus. Part of the tumor was removed with flexible bronchoscopy, and histopathological examination revealed cartilage tissue but not fat or other components. Lobectomy of the right upper lobe of the lung was performed to make a definite diagnosis and prevent recurrent obstructive pneumonia. The resected tumor contained mature cartilage and fat tissues, and was diagnosed as endobronchial hamartoma.
Conclusions: Benign endobronchial tumors such as hamartomas should be considered in the differential diagnosis of post-obstructive pneumonia.
Keywords: Biopsy, Aged, Bronchial Diseases - diagnosis, Bronchoscopy, Diagnosis, Differential, Hamartoma - diagnosis, Humans, Male, Pneumonia - etiology, Tomography, X-Ray Computed