ABSTRACT
We suspected Birt-Hogg-Dubé syndrome (BHDS) from intraoperative findings of emergency operation for idiopathic hemopneumothorax. A 34-year-old man was delivered to our center due to sudden chest pain and dyspnea. Under the diagnosis of hemopneumothorax, emergency operation was performed. During surgery, multiple thin wall lung cysts of 2 to 5 mm in size were observed on the surface of all lung lobes. BHDS was suspected, but the surgery was limited to hemostasis and resection of pulmonary cyst since the diagnosis had not been established. Postoperative chest computed tomography (CT) revealed irregular shaped pulmonary cyst on the interlobar, mediastinal and diaphragm surface. Genetic analysis showed deletion in the folliculin gene confirming the diagnosis of BHDS.
Subject(s)
Birt-Hogg-Dube Syndrome/diagnosis , Hemopneumothorax/surgery , Adult , Birt-Hogg-Dube Syndrome/genetics , Gene Deletion , Humans , Incidental Findings , Male , Proto-Oncogene Proteins/genetics , Tumor Suppressor Proteins/geneticsABSTRACT
OBJECTIVES: The purpose of this study is to assess retrospectively our treatment strategy for chronic pulmonary aspergillosis(CPA). PATIENTS AND METHOD: From 2002 to 2015, 11 patients underwent pulmonary resection for CPA in our hospital. Six patients were diagnosed simple pulmonary aspergilloma (SPA) and 5 were chronic progressive pulmonary aspergillosis(CPPA). Clinical characteristics, preoperative treatment, postoperative treatment, surgical procedure, postoperative complication, recurrence, and prognosis were retrospectively reviewed. RESULTS: Two patients of SPA and 5 of CPPA were treated with antifungal agents preoperatively. Two patients required wedge resection and 4 required lobectomy in SPA. Five patients required lobectomy in CPPA. All patients were treated with antifungal agents postoperatively. One patient presented recurrent disease in both SPA and CPPA. All patients has been alive. CONCLUSION: Surgical resection of CPA leads good results in selected patients. The treatment with surgery with perioperative antifungal treatment is thought to be important based on our experience.
Subject(s)
Pulmonary Aspergillosis/surgery , Antifungal Agents/therapeutic use , Chronic Disease , Disease Progression , Humans , Pneumonectomy , Pulmonary Aspergillosis/drug therapy , Recurrence , Retrospective StudiesABSTRACT
Although many bronchial foreign bodies can be extracted by flexible bronchoscopy, it is sometimes difficult because of size and form of foreign bodies. A 78-year-old man who had been bedridden for 1 year presented to another hospital due to fever and hemoptysis. Chest X-ray showed a dental crown in the left inferior lobe bronchus. Although flexible bronchoscopic extraction was attempted 3 times, the dental crown could not be removed because it was tightly stuck in the bronchus. Open thoracotomy was performed on the next day in our hospital. After dissection of a severe adhesion, we reached the left inferior lobe bronchus from the anterior side of the pulmonary hilum and extracted the crown through a transverse incision of the bronchus. The patient was discharged 7 days after surgery without any complications. Surgical extraction of a bronchial foreign body can be managed safely even in bedridden patients suffering from a brain infarction.
