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Tracheobronchial obstruction due to silicosis
B C Cahill1, K R Harmon, S J Shumway
1University of Minnesota, Minneapolis 55455.
The American Review of Respiratory Disease
|March 1, 1992
Summary
Broncholithiasis, a condition causing airway obstruction, was unusually treated in a silicosis patient with granulation tissue polyps. Surgical removal of calcified lymph nodes and treatment for Mycobacterium avium-intracellulare infection were ultimately required.
Area of Science:
- Pulmonology
- Pathology
Background:
- Broncholithiasis typically causes airway obstruction via calcified lymph node erosion or extrinsic compression.
- Silicosis is a known risk factor for respiratory complications.
Observation:
- A patient with silicosis presented with airway obstruction due to endobronchial polypoid granulation tissue masses near calcified mediastinal lymph nodes.
- Initial YAG laser phototherapy for polyps provided only temporary relief.
Findings:
- Surgical removal of calcified mediastinal lymph nodes was necessary to control polyp growth.
- Surgical specimens revealed Mycobacterium avium-intracellulare (MAI), a common pathogen in silicosis patients.
- MAI may have fueled the inflammatory response leading to excessive granulation tissue formation.
Implications:
- This case highlights an unusual presentation of broncholithiasis in silicosis.
- Mycobacterium avium-intracellulare infection could play a role in the pathogenesis of airway obstruction in such cases.
- A multidisciplinary approach involving interventional pulmonology and thoracic surgery may be necessary for complex broncholithiasis cases.