Abstract

<i>Objective</i> To explore the diagnosis of, clinical characteristics of and effects of interventional therapy for intraluminal central airway spheroid masses. <i>Methods</i> Forty-four patients with intraluminal central airway spheroid masses were summarized retrospectively, and the clinical characteristics and therapy were analysed. <i>Results</i> Cough and shortness of breath were the predominant symptoms, followed by hemoptysis, fever and chest pain. The aetiologic diagnoses were 12 cases of inflammatory granulomas, 5 cases of foreign matter, 5 cases of squamous carcinoma, 4 cases of leiomyoma, 3 cases of lipomyoma, 2 cases of inflammatory myofibroblastic tumor, and one case each of glomus tumor, adenocarcinoma, mucoepidermoid carcinoma, malignant melanoma metastasis, carcinoid, adenoid cystic carcinoma, chondrosarcoma, combined small cell carcinoma, hamartoma, mixed tumor, neurilemmoma, acidophilic adenoma and salivary gland tumor. The numbers of masses located in the trachea, left main bronchus, right main bronchus and bronchus intermedius were 20, 13, 7, and 4, respectively. Electrocautery snare and electrocoagulation probe was the most commonly used interventional therapy method, followed by argon plasma coagulation and cryotherapy; stent implantation was used in 1 case. Thirty-five cases achieved a complete response or partial response after treatment, 8 cases achieved a mild response, and 1 had no response. <i>Conclusion</i> The symptoms of intraluminal central airway spheroid masses were atypical and easily misdiagnosed or missed; benign lesions were the leading cause, and the first pathological type was inflammatory granuloma. Endoscopic intervention was the effective, safe technique.

Highlights

  • The central airway includes the trachea, right and left main bronchi and bronchus intermedius

  • Due to the specific lesion site, many patients have urgent, critical symptoms at the time of treatment, and the disease progresses so quickly that the patients are prone to asphyxia; substantial attention should be paid to these lesions [1]

  • We collected 44 patients with masses that occurred in the central airway and had intracavitary growths with spherical or rounded shapes under direct visualization by a flexible bronchoscope who were seen in the past 6 years in our hospital, analysed the pathologies and effects of interventional therapy, and explored the outcomes and characteristics of these diseases

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Summary

Introduction

The central airway includes the trachea, right and left main bronchi and bronchus intermedius. Central airway obstruction (CAO) caused by intraluminal spherical masses is relatively rare and can be caused by multiple benign or malignant lesions that are misdiagnosed or missed. Intraluminal central airway masses vary in shape; most are irregular, but spheroid masses are occasionally encountered. Very few studies have reported the disease with a description of the morphology of the lesions. We collected 44 patients with masses that occurred in the central airway and had intracavitary growths with spherical or rounded shapes under direct visualization by a flexible bronchoscope who were seen in the past 6 years in our hospital, analysed the pathologies and effects of interventional therapy, and explored the outcomes and characteristics of these diseases. We expect the results of this study to help focus the attention of clinicians on this issue

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