Abstract
A 16-year-old male patient was admitted with complaints of cough, fever, dyspnoea, wheezing and haemoptysis for 2 months. Wheezing was bilateral but predominantly in the right lung fields. Inspiration and expiration were prolonged. In the emergency room, the initial diagnosis was bronchial asthma. His wheezing and dyspnoea did not respond to iv. theophylline, corticosteroids or inhaled salbutamol. Chest X-ray showed hyperinflation of the right lung, especially after full expiration. Mantoux test, acid-fast bacilli and sputum cultures were negative. Magnetic resonance revealed a soft tissue mass in the proximal part of the right main bronchus, and hyperinflation of the right lung (Plate 1). Fiberoptic bronchoscopy showed total occlusion in the proximal part of the right main bronchus. Bronchial leiomyoma was diagnosed in the biopsy specimen. In order to evaluate the extension of mass and distal bronchial distribution, selective bronchography via fiberoptic bronchoscopy was performed. Dionosil aqua was pooled proximal to the mass and the distal bronchial system could not be visualized. Bronchiectasis could visualize by lotrolan (Plates 2 and 3). Lung destruction, bronchiolitis obliterans and bronchiectasis were observed secondary to the endobronchial leiomyoma and right pneumonectomy was performed.
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