Role of Computed Tomography Chest and Bronchoscopy in the Diagnosis of Endobronchial Masses

Abstract

Endobronchial Masses (EBM) can present with Central Airway Obstruction (CAO). Causes of EBM can be benign or malignant in origin. Malignant endobronchial masses are more common than expected. However, they are underdiagnosed because of their non specific clinical and radiological presentations. The authors present a case series of seven cases of endobronchial growth. Three cases were of squamous cell carcinoma, one was bronchioloalveolar carcinoma, one was a typical carcinoid, and another one was Endobronchial Tuberculosis (EBTB). All were males, and five were above 50 years of age. Breathlessness, cough, wheeze, and haemoptysis were the common symptoms. In three patient diagnoses were delayed as Computed Tomography (CT) chest and bronchoscopy were not done during the initial evaluation. In one of the cases, empiric treatments for pulmonary tuberculosis delayed definite diagnoses of endobronchial growths. In another patient, empiric treatments for pleural tuberculosis delayed the diagnosis of carcinoma of the lung. In one patient empiric treatment with corticosteroids for asthma delayed the diagnosis of EBTB. However, in three patients early CT chest and bronchoscopy revealed the diagnoses of different types of carcinomas of the lung despite acute symptoms. One patient had carcinoma of the lung and EBTB. Early and optimal use of chest CT and bronchoscopy can clinch the diagnoses. Investigation should be done for both EBTB and malignancy in a case of endobronchial growth.

Keywords

• airway obstruction
• bronchioloalveolar carcinoma
• carcinoid
• pulmonary tuberculosis
• squamous cell carcinoma