scholarly journals Tracheobronchial Amyloidosis Mimicking Tracheal Tumor

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Elif Tanrıverdi ◽  
Mehmet Akif Özgül ◽  
Oğuz Uzun ◽  
Şule Gül ◽  
Mustafa Çörtük ◽  
...  
Keyword(s):  
Argon Plasma Coagulation ◽  
Amorphous Material ◽  
Argon Plasma ◽  
Rigid Bronchoscopy ◽  
Benign Tumors ◽  
Rare Presentation ◽  
Tracheal Tumor ◽  
Persistent Symptoms ◽  
Neoplastic Lesion ◽  
Tracheobronchial Amyloidosis

Tracheobronchial amyloidosis is a rare presentation and accounts for about 1% of benign tumors in this area. The diagnosis of disease is delayed due to nonspecific pulmonary symptoms. Therapeutic approaches are required to control progressive pulmonary symptoms for most of the patients. Herein, we report a case of a 68-year-old man admitted with progressive dyspnea to our institution for further evaluation and management. He was initially diagnosed with and underwent management for bronchial asthma for two years but had persistent symptoms despite optimal medical therapy. Pulmonary computed tomography scan revealed severe endotracheal stenosis. Bronchoscopy was performed and showed endotracheal mass obstructing 70% of the distal trachea and mimicking a neoplastic lesion. The mass was successfully resected by mechanical resection, argon plasma coagulation (APC), and Nd-YAG laser during rigid bronchoscopy. Biopsy materials showed deposits of amorphous material by hematoxylin and eosin staining and these deposits were selectively stained with Congo Red. Although this is a rare clinical condition, this case indicated that carrying out a bronchoscopy in any patient complaining of atypical bronchial symptoms or with uncontrolled asthma is very important.

Different effects of bronchoscopic interventions on children and adults with tracheobronchial mucoepidermoid carcinoma

2021 ◽  
pp. 030089162199589
Author(s):  
Zhang Jieli ◽  
Zhou Yunzhi ◽  
Zhang Nan ◽  
Zou Heng ◽  
Wang Hongwu ◽  
...  
Keyword(s):  
Mucoepidermoid Carcinoma ◽  
Argon Plasma Coagulation ◽  
Survival Rates ◽  
Argon Plasma ◽  
Rigid Bronchoscopy ◽  
Low Grade ◽  
High Grade ◽  
Adult Group ◽  
Histologic Grading ◽  
Comprehensive Therapy

Aims: To investigate the efficacy and safety of minimally invasive bronchoscopic interventions for patients with tracheobronchial mucoepidermoid carcinoma (MEC). Methods: Patients with tracheobronchial MEC were included in this retrospective study, and the clinical features, histologic grading, treatments, and cumulative survival rates were calculated. Patients were categorized into child (n = 16) and adult (n = 19) group according to their ages. Histologic grading, treatments, and survival status were compared between the two groups. Results: In pathology, high-grade MEC counts for 6.77% and 42.10% in the child and adult group, respectively. As tumor growth pattern was concerned, 93.33% and 21.05% tumors in the child and adult group present intratracheal type. Multiple bronchoscopic interventions were conducted, including rigid bronchoscopy, argon plasma coagulation (APC), dioxide carbon cryotherapy, and electric loop. Tumors could be removed by multiple bronchoscopic interventions. Bronchoscopy-associated complications were rare, including an oral mucosa injury and a glottis edema. In the child group, one patient underwent left upper lung lobectomy. In the adult group, lobectomy and/or chemotherapy and/or radiotherapy were conducted in seven patients. The 5-year survival rate was 100% and 68.90% in the child and the adult group, respectively. Conclusions: Almost all children have low-grade and intratracheal MEC; 2/5 adults have invasive high-grade MEC. Multiple bronchoscopic interventions are effective in erasing low-grade intratracheal MEC without severe complications. For high-grade invasive MEC, aggressive and comprehensive therapy should be considered.

scholarly journals Primary intratracheal schwannoma resected during bronchoscopy using argon plasma coagulation

2018 ◽  
pp. bcr-2018-225140
Author(s):  
Purva V Sharma ◽  
Yash B Jobanputra ◽  
Tatiana Perdomo Miquel ◽  
J Ryan Schroeder ◽  
Adam Wellikoff
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Cost Effective ◽  
Rigid Bronchoscopy ◽  
Vascular Lesions ◽  
Interventional Bronchoscopy ◽  
Plasma Coagulation ◽  
Nd:Yag Lasers ◽  
Initial Work ◽  
Contrast Ct

A 63-year-old man presented with intermittent, progressively worsening dyspnoea associated with cough and blood-tinged sputum. Initial work-up showed left axis deviation on ECG, chest X-ray with an elevated left hemidiaphragm and a non-contrast CT chest that showed a multilobulated mass in the proximal trachea. Bronchoscopy showed a whitish-appearing lesion, which was then sampled and partially resected with pathology showing a schwannoma with no malignant cells. He felt partial relief post procedure; however, he presented a month later with similar symptoms of dyspnoea and a repeat CT scan showed enlargement of the mass in the same location. The patient underwent another flexible bronchoscopy and resection with argon plasma coagulation (APC)/electrocautery snare. APC/electrocautery is an effective interventional bronchoscopy technique that can be used to resect endoluminal lesions or extraluminal lesions that have infiltrated into the airway using flexible/rigid bronchoscopy. It is more cost-effective, safe, works well with vascular lesions and achieves excellent haemostasis as compared with Nd:YAG lasers.

scholarly journals Successful treatment of post-intubation tracheal stenosis with balloon dilation, argon plasma coagulation, electrocautery and application of mitomycin C

2015 ◽  
Vol 3 (9) ◽  
pp. 14
Author(s):  
Audra Fuller ◽  
Mark Sigler ◽  
Shrinivas Kambali ◽  
Raed Alalawi
Keyword(s):  
Mitomycin C ◽  
Topical Application ◽  
Tracheal Stenosis ◽  
Argon Plasma Coagulation ◽  
Balloon Dilation ◽  
Argon Plasma ◽  
Rigid Bronchoscopy ◽  
Definitive Treatment ◽  
Plasma Coagulation ◽  
Post Intubation

Tracheal stenosis is an uncommon but known complication of endotracheal intubation and tracheostomy. Surgery is currently the definitive treatment for tracheal stenosis but carries a significantly higher risk for adverse events as it often involves complex procedures.  Here we present our experience using topical application of mitomycin C, along with various bronchoscopic interventions, as a treatment for tracheal stenosis. The patients in our series developed tracheal stenosis post-intubation or post-tracheostomy. Each patient in our series underwent the same basic procedures involving rigid bronchoscopy and balloon dilation, ablation of granulation tissue with cryotherapy and argon plasma coagulation, and finally application of topical mitomycin C. Our experience with these four cases shows a good initial success rate with topical mitomycin C application for the treatment of tracheal stenosis. Most patients required a repeat intervention a few weeks later. Our results suggest that success with topical mitomycin C is more likely in post-intubation rather than post-tracheostomy tracheal stenosis. Bronchoscopic therapy and topical application of mitomycin C may work better as a bridge to definitive surgery rather than as a stand-alone therapy.

scholarly journals Therapeutic bronchoscopy for central airway diseases

2020 ◽  
Vol 29 (158) ◽  
pp. 190178
Author(s):  
Antoni Rosell ◽  
Grigoris Stratakos
Keyword(s):  
Argon Plasma Coagulation ◽  
Three Dimensional ◽  
Argon Plasma ◽  
Massive Bleeding ◽  
Rigid Bronchoscopy ◽  
Metal Stents ◽  
Past Century ◽  
Airway Diseases ◽  
Dedicated Team ◽  
Central Airway

Over the past century rigid bronchoscopy has been established as the main therapeutic means for central airway diseases of both benign and malignant aetiology. Its use requires general anaesthesia and mechanical ventilation usually in the form of manual or high-frequency jet ventilation. Techniques applied to regain patency of the central airways include mechanical debulking, thermal ablation (laser, electrocautery and argon plasma coagulation) and cryo-surgery. Each of these techniques have their advantages and limitations and best results can be attained by combining different modalities according to the type, location and extent of the airway blockage. If needed, deployment of airway endoprostheses (stents), as either fixed-diameter silicone or self-expandable metal stents, may preserve the airways patency often at the cost of several complications. Newer generation of customised stents either three-dimensional printed or drug-eluting stents constitute a promise for improved safety and efficacy results in the near future. Treating central disease of benign or malignant aetiology, foreign body aspiration or massive bleeding in the airways requires a structured approach with combined techniques, a dedicated team of professionals and experience to treat eventual complications. Specific training and fellowships in interventional pulmonology should therefore be offered to those who wish to specialise in this field.

scholarly journals Endobronchial Schwannoma Treated by Rigid Bronchoscopy with Argon Plasma Coagulation

2012 ◽  
Vol 73 (3) ◽  
pp. 174 ◽  
Author(s):  
Bo Ram Lee ◽  
Yoo Duk Choi ◽  
Yu Il Kim ◽  
Sung Chul Lim ◽  
Yong Soo Kwon
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Rigid Bronchoscopy ◽  
Plasma Coagulation

Safety of Laser and Thermal Therapy During Rigid Bronchoscopy Using Manual Hand Jet Ventilation

2021 ◽  
Vol 39 ◽  
Author(s):  
Amit Mahajan ◽  
◽  
Priya Patel ◽  
Radhika Garg ◽  
Christopher Manley ◽  
...  
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Rigid Bronchoscopy ◽  
Thermal Therapy ◽  
Breath Hold ◽  
Jet Ventilation ◽  
Study Objective ◽  
Ablative Therapies ◽  
Thermal Therapies ◽  
Airway Obstructions

Introduction: Thermal ablative therapies (laser, radiofrequency ablation, electrocautery, argon plasma coagulation) are often used during rigid bronchoscopy for the treatment of central airway obstructions (CAO). An airway fire is a feared complication that can occur during endobronchial thermal ablation. Materials and Methods: This was a single-center, retrospective, observational study. A total of 175 patients were reviewed undergoing rigid bronchoscopy in the operating room and bronchoscopy suite requiring manual hand jet ventilation and thermal therapy between September 2014 and September 2018. The study objective was to determine the safety of manual hand jet ventilation during endobronchial thermal therapies with rigid bronchoscopy. Results: Over a five-year period, 175 patients underwent endobronchial thermal therapy during rigid bronchoscopy with manual hand jet ventilation for the treatment CAOs. Immediately prior to thermal therapy activation, jet ventilation was paused. No incidences (0/175) of airway fires occurred despite immediate delivery of thermal energy following a jet ventilation hold. Conclusions: Results of our study show that performing thermal ablative therapy during rigid bronchoscopy with jet ventilation using a breath-hold technique is safe.

scholarly journals Bronchoscopic Treatment of Benign Endoluminal Lung Tumors

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Levent Dalar ◽  
Cengiz Ozdemir ◽  
Sinem Nedime Sokucu ◽  
Halide Nur Urer ◽  
Sedat Altin
Keyword(s):  
Diode Laser ◽  
Tumor Regression ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Major Complication ◽  
Treatment Modalities ◽  
Benign Tumors ◽  
Minor Bleeding ◽  
Eligibility Criteria ◽  
Plasma Coagulation

Background and Aim. Endobronchial benign tumors are a rarely seen clinical entity but may cause significant symptoms. Endobronchial treatment has the potential for relieving symptoms while saving the patient from invasive surgical procedures. No trials have been published that present and compare the various endobronchial treatment modalities for endobronchial benign tumors. The aim of the present study is to define safety and efficacy of endobronchial treatment in patients with benign endobronchial tumors from the point of complications and success rate.Methods. This study is a retrospective cohort study from a review of medical charts. Eligibility criteria included diagnosis of a benign endobronchial tumor. Our institution’s bronchoscopy and pathology database was searched for specific benign tumors, and the results were further detailed based on the endobronchial location.Results. Forty-four patients with pathologically confirmed benign endobronchial tumors were included. Tumor regression was achieved in all patients with diode laser and argon plasma coagulation in combination with or without cryotherapy and without any major complication. There were no significant differences between the use of either diode laser or of argon plasma coagulation as a modality with immediate effect from the occurrence of residual tissue that needed cryotherapy (P>0.05). There were no major complications. Eight patients had minor complications including minor bleeding (6 patients) and hypertension (2 patients) that were controlled medically. Thirty-one patients (70%) had very good response, and 13 patients (30%) had good response as defined in literature before.Conclusion. Diode laser and argon plasma coagulation in combination with or without cryotherapy are safe and effective methods for endobronchial treatment of benign endobronchial tumors.

Surgical tactics for benign bronchial and lung tumors

MedAlliance ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 62-67
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Charlson Index ◽  
Benign Tumors ◽  
Video Assisted ◽  
Urgent Surgery ◽  
Co Morbidity ◽  
Surgical Tactics ◽  
Pulmonary Tumors ◽  
Tumors Of The Lungs

Aim: to identify the efficient surgical tactics in case of benign broncho-pulmonary tumors taking into account co-morbidities and possibilities of video-assisted thora- cic operations. Materials and methods. Among 133 pa- tients with benign tumors of the lungs and bronchi 128 (96%) had tumors of peripheral localization, 5 (4%) — of the central one. All patients with peripheral tumors were operated on. Charlson index was used to assess the co-morbidity. Results. In 120 (90.2%) patients tumors were diagnosed during routine Х-ray examination or casual check-up.6 (4.5%) patients showed clinical symp- toms. The average terms of observation of patients with peripheral tumors were 7.8 months (Me — 6, Q1 — 2, Q3 — 7), with the central ones — 13.3 months (Me — 5, Q1 — 3, Q3 — 8). In 4 cases central tumors were removed by endoscopy methods using electroresection and argon plasma coagulation. In one case a stent was inserted. More than 2/3 of patients had co-morbid pathologies. Charlson index in co-morbid patients was 2.4±1.4, in the group of patients elder than 70 years — 4.8±0.9. All patients with peripheral tumors were operated on. The video thoracoscopy approach was used in 56 (42.1%) pa- tients, thoracotomy — in 67 (50.4%), video-assisted mi- nithoracotomy — in 6 (4.5%). In 5.2% of cases thoracosco- py was converted to thoracotomy. All peripheral tumors were mesenchymal ones. Post-operative complications developed in 7 (5.5%) patients. There were no mortality. Conclusion. Peripheral benign tumors of the lungs are asymptomatic and require urgent surgery with an express histology test to rule out lung cancer. Central tumors are mostly removed by endoscopy. Video thoracoscopy is the most efficient method to remove peri pheral tumors. Conversion to thoracotomy is usually necessary in case of a small size and deep tumor localization.

scholarly journals Bronchoscopic Diagnosis and Treatment of Primary Tracheobronchial Amyloidosis: A Retrospective Analysis from China

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Xiaoxiao Lu ◽  
Bixiu He ◽  
Ge Wang ◽  
Baimei He ◽  
Lijing Wang ◽  
...  
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Diagnosis And Treatment ◽  
Wall Thickening ◽  
Short Term ◽  
Efficacy Evaluation ◽  
Luminal Stenosis ◽  
Bronchoscopic Biopsy ◽  
Primary Means ◽  
Tracheobronchial Amyloidosis

Objective. To assess the value of bronchoscopy in the diagnosis and treatment of primary tracheobronchial amyloidosis (TBA), in order to reduce misdiagnosis rates and improve prognosis. Methods. Clinical data of 107 patients with TBA reported from 1981 to 2015 in China were retrospectively analyzed for clinical features, bronchoscopic manifestations, pathologies, treatments, and outcomes. Results. 105 of 107 TBA patients were pathologically confirmed by bronchoscopy. Main bronchoscopic manifestations of TBA were single or multiple nodules and masses within tracheobronchial lumens; local or diffuse luminal stenosis and obstruction; luminal wall thickening and rigidity; rough or uneven inner luminal walls; congestion and edema of mucosa, which was friable and prone to bleeding upon touch; and so forth. 53 patients were treated with bronchoscopic interventions, like Nd-YAG laser, high-frequency electrotome cautery, freezing, resection, clamping, argon plasma coagulation (APC), microwaving, stent implantation, drug spraying, and other treatments. 51 patients improved, 1 patient worsened, and 1 died. Conclusion. Bronchoscopic biopsy is the primary means of diagnosing TBA. A variety of bronchoscopic interventions have good short-term effects on TBA. Bronchoscopy has important value in the diagnosis, severity assessment, treatment, efficacy evaluation, and prognosis of TBA.

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