Chest
Clinical InvestigationsStenosis of Main Bronchi Mimicking Fixed Upper Airway Obstruction in Sarcoidosis
Section snippets
Case 1
A 32-year-old black woman was first seen in March of 1982 with marked exacerbation of her usual dyspnea and noisy respirations. She had a history of “asthma” beginning in 1977 attributed to working with “hot glue” at a cardboard carton factory. She had had no previous pulmonary or allergic symptoms or illness and was a nonsmoker. She had received workmen's compensation and had had repeated admissions to other hospitals for her symptoms, with PaCO2 values up to 50 mm Hg. After intensive care
Discussion
The locus of obstruction in both main bronchi, rather than in the upper airways, makes the clinical presentation and physiologic alterations otherwise characteristic of fixed UAO noteworthy.
Patient 1 had no clinical evidence of sarcoidosis other than the enlarged lacrimal glands which provided the clue for obtaining a tissue diagnosis. For several years, she had been mistakenly treated for “occupational asthma” because of progressive respiratory distress and “wheezing” which was really stridor.
ACKNOWLEDGMENT
This investigation was supported by the Jack Martin Fund.
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Progressive Stenosis of Both Main Bronchi Associated With Recurrent Infections of a Carinal Pouch
2018, Annals of Thoracic SurgeryCitation Excerpt :Reports on similar cases in literature are rare. In adults, sarcoidosis can present as stenosis at the carinal level or of both main bronchi, similar to the patient presented here [1]. However, sarcoidosis was ruled out in our patient.
Clinical case no. 5: Obstructive lung disease during sarcoidosis
2017, Revue des Maladies Respiratoires ActualitesBronchoscopic Management of Sarcoidosis Related Bronchial Stenosis With Adjunctive Topical Mitomycin C
2010, Annals of Thoracic SurgeryCitation Excerpt :Three main patterns of involvement may occur: (1) single, (2) multiple, or (3) diffuse airway narrowing, and multiple involvement is most frequent [1]. Bronchoscopic improvement is limited, despite high-dose systemic steroids, and this may be attributable to intraluminal fibrotic changes [2–4]. Only one retrospective study suggested more promising data that describes 18 patients whose early treatment with systemic steroids within 3 months of diagnosis was associated with symptom relief, spirometric improvement, and endoscopic resolution [1].
Nonneoplastic Tracheal and Bronchial Stenoses
2010, Thoracic Surgery ClinicsCitation Excerpt :The proximal and distal parts of the trachea may be affected, and the appearance of the stenosis may be smooth, irregular and nodular, or even mass-like. Bronchial involvement is much more common as a manifestation of sarcoidosis.61 It was reported in 65% of 60 patients with sarcoidosis in a study by Lenique and colleagues62 using high resolution computed tomography.
Airway involvement in sarcoidosis
2009, ChestNonneoplastic Tracheal and Bronchial Stenoses
2009, Radiologic Clinics of North AmericaCitation Excerpt :The proximal and distal parts of the trachea may be affected, and the appearance of the stenosis may be smooth, irregular and nodular, or even mass-like. Bronchial involvement is much more common as a manifestation of sarcoidosis.61 It was reported in 65% of 60 patients with sarcoidosis in a study by Lenique and colleagues62 using high resolution computed tomography.
Manuscript received October 22; revision accepted December 20.