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Open Access Case report

Bronchial cast hiding a lung cancer

Marcello Migliore13*, Nicola Ciancio2, Riccardo Giuliano2 and Giuseppe Di Maria2

Author Affiliations

1 Thoracic Surgery, University of Catania, Catania, Italy

2 Respiratory Medicine, University of Catania, Catania, Italy

3 Department of Surgery, Thoracic Surgery, Policlinico Hospital, Via S. Sofia 78, Catania, Italy

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Multidisciplinary Respiratory Medicine 2012, 7:43  doi:10.1186/2049-6958-7-43

Published: 13 November 2012

Abstract

A 70-year-old man was admitted for severe hypoxia, haemoptysis and cough. Chest-X-ray and CT-scan indicated a right-lower-lobe collapse. Bronchoscopy showed its occlusion by whitish dense mucus. Aspiration revealed a Bronchial Cast (BC) and a stenotic and inflamed orifice of the right-lower-lobe-bronchus which was biopsied.

Histopathologic examination of BC showed fibrin with lymphocytes and neutrophils, and, surprisingly, also the presence of lung cancer. Although the association between BC and benign, myxoid-soft-tissue, tracheobronchial tumors has been described, the association with lung cancer has not previously been reported, and it remains unclear whether it is causal or casual.

Keywords:
Airway obstruction; Bronchial cast; Broncoscopy; Haemoptysis; Lung cancer; NSCLC