Main Bronchus Research Articles

Extraction of Foreign Body in Left Main Bronchus with Flexible Optical Bronchoscopy in Asymptomatic Needle Aspiration Patient: A Case Report

Background: Foreign body aspiration is one of the most common respiratory and airway emergencies. The incidence is higher in children and obstruction occurrences are common. The late complications might be fatal when ignored. Bronchoscopy as a gold standard modality in diagnosing and treating this condition, now is widely available, and the emerging flexible optic bronchoscopy (FOB) is more commonly used.Case: A ten-year-old girl with a history of needle aspiration arrived at the ER with an asymptomatic condition. Further investigations reveal leucocytosis and a metal-needle-shaped foreign body found approximately in the left main bronchus via chest x-ray and CT scan. Bronchoscopy with FOB was performed under general anesthesia and LMA and successfully evacuated the needle although the pin had infiltrated the mucosal wall.Discussion: Asymptomatic foreign body aspiration is nearly at the same rate as symptomatic one. Management of difficulties and complications increases the longer the foreign body infiltrates the respiratory tract. Early diagnosis with chest x-ray and CT scan is necessary. Prompt and urgent evacuation of the foreign body is required. The use of FOB is associated with a higher success rate and lower complications. FOB is the best modality choice in this case.Conclusion: The foreign body in the respiratory tract may be asymptomatic. Early and proper diagnosis must be worked out as early management of asymptomatic foreign body aspiration. Early FOB can be used as a modality of choice in this case, preventing further damage to the respiratory tract.

Lower Left Lobectomy for Bronchial Dilation Revealing a Food Foreign Body (Sunflower Seed) about of an Observation

Inhalation of a food foreign body is a rare phenomenon in adults, it can be serious and life-threatening. We report the observation of a 37-year-old patient with chronic bronchitis for 10 years, without notion of ingestion of an obvious digestive foreign body but who presents a progressive worsening of her bronchorrhea becoming purulent associated with a single episode of hemoptysis of low abundance. Chest radiography revealed an alveolar type opacity with left paracardiac projection. The chest CT scan showed dilatation of the bronchi downstream of a lesion at the left lower lobar level. The flexible bronchoscopy showed a foreign body which is a sunflower seed obstructing the orifice of the left lower lobar bronchus with notion of regular consumption of Sunflower seeds for 20 years later found during interrogation. The extraction of the foreign body was carried out surgically or a lower lobectomy was carried out in connection with the failure of the endoscopic extraction and the patient benefited from antibiotic therapy and respiratory physiotherapy, as well as awareness raising in order to avoid subsequent penetration syndrome. The development was very favorable. Intrabronchial foreign bodies after failure of their extraction by bronchial endoscopy.

Usefulness of final transection of the proximal pulmonary artery in robotic left upper lobectomy.

The pulmonary artery runs around the left upper bronchus, which poses the risk of blood vessel injury when cutting in the blind spot of the bronchus. During robotic surgery, the robotic arm holds the tissue under constant tension; therefore, even if the pulmonary artery is left for final transection, it is not injured by unexpected tension. In this study, we examined the usefulness of final transection of the proximal pulmonary artery in robotic left upper lobectomy. This retrospective single-institution study evaluated patients who had undergone robotic lung resection. Of the 453 robotic lung resections performed at our institution between 2017 and 2022, 49 patients who had undergone left upper lobectomy were evaluated. Patients who had undergone bronchial transection followed by pulmonary artery transection were assigned to the group, bronchus prior transection (BT group, n = 38), and those who had undergone pulmonary artery transection followed by bronchial transection were assigned to the group, pulmonary artery prior transection (AT group, n = 11). Patient characteristics and perioperative outcomes were compared between the groups. The groups did not differ significantly in age, sex, smoking history, tumour size, complication rates or 30-day mortality. The BT group inclined to shorter operative times and lesser blood loss. No active intraoperative bleeding occurred in the BT group. However, the AT group had 2 cases of intraoperative pulmonary artery bleeding, one of which required urgent conversion to thoracotomy. Final transection of the proximal pulmonary artery is a novel and effective surgical technique for robotic left upper lobectomy.

Feasibility of Continuous Bronchoscopy During Exercise in the assessment of large airway movement in healthy subjects.

Excessive dynamic airway collapse (EDAC) is a recognized cause of exertional dyspnea arising due to invagination of the trachea and/ or main bronchi. EDAC is typically assessed by evaluating large airway movement with forced expiratory maneuvers. This differs from the respiratory response to exercise hyperpnea. We aimed to evaluate large airway movement during physical activity, with continuous bronchoscopy during exercise (CBE), in healthy subjects and compare findings with resting bronchoscopic maneuvers and imaging techniques. Twenty-eight individuals were recruited to complete two visits including treadmill-based CBE, to voluntary exhaustion and cine magnetic resonance imaging (MRI) with forced expiratory maneuvers at rest. 25 subjects (aged 29 (26 - 33) years, 52% female) completed the study (n=2 withdrew before bronchoscopy, and one was unable to tolerate insertion of bronchoscope). The majority (76%) achieved a peak heart rate of >90% predicted during CBE. The procedure was prematurely terminated in five subjects (n=3; elevated blood pressure and n=2; minor oxygen desaturation). The CBE assessment enabled adequate tracheal visualization in all cases. Excessive dynamic airway collapse (tracheal collapse ≥50%) was identified in 16 subjects (64%) on MRI, and in 6 (24%) individuals during resting bronchoscopy, but in no cases with CBE. No serious adverse events were reported, but minor adverse events were evident. The CBE procedure permits visualization of large airway movement during physical activity. In healthy subjects, there was no evidence of EDAC during strenuous exercise, despite evidence during forced maneuvers on imaging, thus challenging conventional approaches to diagnosis.

Individualized rotation of left double lumen endobronchial tube to improve placement success rate: a randomized controlled trial

BackgroundIn conventional practice, the left double lumen tube (DLT) is rotated 90° counterclockwise when the endobronchial cuff passes glottis. Success rate upon the first attempt is < 80%, likely owing to varying morphology of the bronchial bifurcation.MethodsWe conducted a randomized controlled trial to compare 90° counterclockwise rotation versus individualized degree of rotation in adult patients undergoing elective thoracic surgery using left DLT. The degree of rotation in the individualized group was based on the angle of the left main bronchi as measured on computed tomography (CT). The primary outcome was the first attempt left DLT placement success rate.ResultsA total of 556 patients were enrolled: 276 in the control group and 280 in the individualized group. The average angle of the left main bronchi was 100.6±9.5° (range 72° to 119°). The first attempt left DLT placement success rate was 82.6% (228/276) in the control group versus 91.4% (256/280) in the individualized group (P=0.02, χ2 test). The rate of carina mucosal injury, as measured at 30 min after the start of surgery under fibreoptic bronchoscopy, was significantly lower in individualized group than control group (14.0% versus 19.6%, P=0.041). The individualized group also had lower rate of postoperative sore throat (29.4% versus 44.0%, P<0.001) and hoarseness (16.8% versus 24.7%, P＜0.05).ConclusionsIndividualized rotation of left DLT based on the angle of the left main bronchi on preoperative CT increased first attempt success rate in adult patients undergoing elective thoracic surgery.Trial registrationThe trial is registered at Chinese Clinical Trial Registry (ChiCTR2100053349; principal investigator Xiang Quan, date of registration November 19, 2021).

Foreign Body in the Main Bronchus: Radiological Signs, Complications, and Differential Diagnosis

No abstract available.

Protecting the non-operative lobe/s of the operative lung can reduce the pneumonia incidence after thoracoscopic lobectomy: a randomised controlled trial

Lung isolation usually refers to the isolation of the operative from the non-operative lung without isolating the non-operative lobe(s) of the operative lung. We aimed to evaluate whether protecting the non-operative lobe of the operative lung using a double-bronchial blocker (DBB) with continuous positive airway pressure (CPAP) could reduce the incidence of postoperative pneumonia. Eighty patients were randomly divided into two groups (n = 40 each): the DBB with CPAP (Group DBB) and routine bronchial blocker (Group BB) groups. In Group DBB, a 7-Fr BB was placed in the middle bronchus of the right lung for right lung surgery and in the inferior lobar bronchus of the left lung for left lung surgery. Further, a 9-Fr BB was placed in the main bronchus of the operative lung. In Group BB, routine BB placement was performed on the main bronchus on the surgical side. The primary endpoint was the postoperative pneumonia incidence. Compared with Group BB, Group DBB had a significantly lower postoperative pneumonia incidence in the operative (27.5% vs 5%, P = 0.013) and non-operative lung (40% vs 15%) on postoperative day 1. Compared with routine BB use for thoracoscopic lobectomy, using the DBB technique to isolate the operative lobe from the non-operative lobe(s) of the operative lung and providing CPAP to the non-operative lobe(s) through a BB can reduce the incidence of postoperative pneumonia in the operative and non-operative lungs.

Pulmonary Mucormycosis: A Case Report and Systematic Review of the Literature

The pulmonary mucormycosis (PMM) caused by Mucorales is a highly lethal invasive fungal infection in which early diagnosis and management is imperative. Otherwise, the mortality may exceed 80%. PMM does not have specific symptoms; hence, awareness of the disease and the treating physician’s suspicion can detect or diagnose it earlier. The fungal infection also needs to be differentiated from aspergillosis and other common fungal infections so an appropriate treatment is instituted.Case Report: A 62-year-old male was admitted with a six-month cough with scanty expectoration and a short history of progressive breathlessness for the last five days. He had a known case of diabetes and also an old-treated case of tuberculosis. He had a history of COVID-19 pneumonia (without a positive report). No history of fever, chest pain and hemoptysis. However, chest X-ray and HRCT thorax revealed a fibro-cavitary lesion in the right upper lobe with sputum and CBNAAT negative for AFB. The FOB examination detected complete occlusion with protruded soft yellowish and black material in the right main upper lobe bronchus, which was reported as mucormycosis. The patient was treated with amphotericin and then with oral antifungal.Discussion: An upsurge of mucormycosis was reported in our country during the COVID-19 era, leaving behind aspergillosis and another fungus. The rhino-orbit-cerebral is the most common site for this fungal infection and is essentially reported in an immune-compromised host as happened in our diabetic patient but as PMM. The Post TB sequelae with residual fibro-cavitary lesions, COPD and solid organ transplantation cases are the other risk factors and our country has enough of a vulnerable population. Our case was detected in the post-Covid period and required attention to epidemiological change or something else?Conclusion: An early rapid diagnosis and management of mucormycosis is crucial to minimizing mortality. The treatment by amphotericin is the best choice followed by Posaconazole or Isavuconazole as step-down oral medication. The increasing incidence of this infection in our country is challenging,

Hyalinizing clear cell carcinoma of the left main bronchus diagnosed with Ewing sarcoma breakpoint region 1::activating transcription factor 1 fusion: A case report

Rationale: Hyalinizing clear cell carcinoma (HCCC) of the bronchus is extremely rare. In addition, its rarity makes an accurate histological diagnosis difficult. Herein, we report a case of HCCC in the left main bronchus diagnosed by the detection of Ewing sarcoma breakpoint region 1::activating transcription factor 1 (EWSR1::ATF1) fusion transcript using reverse transcription-polymerase chain reaction (RT-PCR). Patient concerns: A 56-year-old woman presented with a tumor obstructing the left main bronchus on physical examination computed tomography. A bronchoscopic biopsy confirmed a malignant tumor but did not provide a definitive diagnosis. Interventions: Sleeve resection of the left main bronchus was performed. The intraoperative frozen section was negative for cancer in both the proximal and distal bronchial stumps. Diagnosis: General immunohistochemical staining was performed, and mucoepidermoid carcinoma and HCCC were suspected. RT-PCR revealed positive results for EWSR1::ATF1 fusion transcript, and the tumor was finally diagnosed as HCCC. Outcomes: The patient was discharged without any postoperative complications. Sixty-five months have passed since surgery, and no cancer recurrence has been observed. Lessons: Although hematoxylin and eosin staining and immunostaining alone were not sufficient to distinguish HCCC from mucoepidermoid carcinoma and other malignant tumors, adding genetic testing for EWSR1 rearrangement led to a definitive pathological diagnosis.

Murine Left Pulmonary Hilar Clamp Model of Lung Ischemia Reperfusion Injury.

Ischemia reperfusion injury (IRI) during lung transplantation is a major risk factor for post-transplant complications, including primary graft dysfunction, acute and chronic rejection, and mortality. Efforts to study the underpinnings of IRI led to the development of a reliable and reproducible mouse model of left lung hilar clamping. This model involves a surgical procedure performed in an anesthetized and intubated mouse. A left thoracotomy is performed, followed by careful lung mobilization and dissection of the left pulmonary hilum. The hilar clamp involves reversible suture ligation of the pulmonary hilum with a slipknot, which stops the arterial inflow, venous outflow, and airflow through the left mainstem bronchus. Reperfusion is initiated by careful removal of the suture. Our laboratory uses 30 min of ischemia and 1 h of reperfusion for the experimental model in the current investigations. However, these time periods can be modified depending on the specific experimental question. Immediately prior to sacrifice, arterial blood gas can be obtained from the left ventricle after a 4 min period of right hilar clamping to ensure that the PaO2 values obtained are attributed to the injured left lung alone. We also describe a method to measure cell extravasation with flow cytometry, which involves intravenous injection of a fluorochrome-labeled antibody specific for the cell(s) to be studied prior to sacrifice. The left lung can then be harvested for flow cytometry, frozen or fixed, paraffin-embedded immunohistochemistry, and quantitative polymerase chain reaction. This hilar clamp technique allows fordetailed study of the cellular and molecular mechanisms underlying IRI. Representative results reveal decreased left lung oxygenation and histologic evidence of lung injury following hilar clamping. This technique can be readily learned and reproduced by personnel with and without microsurgical experience, leading to reliable and consistent results and serving as a widely adoptable model for studying lung IRI.

A rare and late complication of lung cancer: bronchial rupture

Abstract Background Tracheobronchial injuries generally occur due to iatrogenic or traumatic causes. Although bronchial rupture due to teratoma and germ cell tumors has been reported in the literature, no cases related to lung cancer have been determined. Our case is presented because of the refusal to be examined for the mass in the lung and the detection of bronchial rupture afterward when he presented with massive hemoptysis. Case presentation A 65-year-old male patient was admitted to the emergency department with the complaint of massive hemoptysis. Six months ago, bronchoscopy was recommended due to the 8 × 7 cm cavitary lesion obliterating the bronchus in the anterior upper lobe of the right lung on chest computed tomography, but the patient refused. The sputum sample, requested 3 times, was negative for acid-resistant bacteria, and no growth was detected in the mycobacterial culture. In the new pulmonary CT angiography, a progressive cavitary lesion invading the right main bronchus, carina, and vena cava superior was observed. Following tranexamic acid treatment and bronchial artery embolization, hemoptysis significantly decreased in the follow-up. In the flexible bronchoscopy performed for diagnostic purposes, the carina was pushed to the left and invaded, and there was damage to the right main bronchus. A biopsy was not performed due to the risk of bleeding, and lavage was performed. Lavage was negative for ARB, there was no growth in the mycobacteria culture, and cytology did not reveal malignant cells. The patient, diagnosed with right main bronchial rupture, was considered inoperable and died 1 month later due to respiratory failure. Conclusions Examinations should be initiated as soon as malignancy is suspected. When diagnosis and treatment are delayed, complications that would be challenging to intervene may develop.

Understanding the Mechanisms of Main Bronchial Compression in Patients with Intracardiac Anomalies

BackgroundThe study focuses on vascular compression of the main bronchus in the aortopulmonary space, examining potential contributors within the same axial plane. Its goal is to uncover mechanisms of bronchial compression in patients with intracardiac anomalies and review surgical outcomes, aiming to enhance future results. MethodsThe morphology and topology of structures within the axial plane of the aortopulmonary space were objectively analyzed, including the sternum, ascending aorta, heart, pulmonary artery, descending aorta, and other relevant elements. Identified deviations from the normal configuration were systematically identified. Operative procedures included mobilizing and removing the compressing vessel, followed by suspending the airway wall to a rigid prosthesis (external stenting), vertebra, or ascending aorta. ResultsComputed tomography revealed potential factors contributing to bronchial stenosis, including anteriorly deviated descending aorta (20 patients), dilated pulmonary artery (6), cardiomegaly (12), flat chest (7), funnel chest (3), posteriorly deviated ascending aorta after arterial switch operation (3), low aortic arch (3), and aberrant subclavian artery (2). Kaplan-Meier analysis demonstrated operative survival rates of 96% at 1 year, 87% at 5 years, and 80% at 8-15 years. Ten-year follow-up computed tomography after external stenting procedure revealed the narrowest diameter of the stented bronchus as 94.4% of the reference. ConclusionsConsistent long-term airway patency was observed post-surgery. While the pulmonary artery and descending aorta exert direct compressive effects in most cases, various other potential mechanisms may contribute to bronchial compression. Identifying and addressing these factors through a multidisciplinary approach is crucial for sustaining bronchial patency and preventing complications.

The overview of the performed robot-assisted minimally invasive bronchial resection with primary anastomosis for schwannoma arising from left main bronchus.

The overview of the performed robot-assisted minimally invasive bronchial resection with primary anastomosis for schwannoma arising from left main bronchus.

Foreign body aspiration in children: our pediatric tertiary care experience.

Inhalation of a foreign body is a real emergency in pediatric age and requires prompt diagnosis and treatment to reduce mortality. The objective of this study is to analyze clinical and radiological details, types, and localization of foreign bodies in patients conducted or to our hospital with suspected inhalation. We conducted a retrospective analysis of all cases of foreign body inhalation admitted to our Pediatric Emergency Room between January 2009 and June 2022. 171 patients were included in the study. In 83 patients, the FB was detected. The mean age of presentation was 2.3years (SD: ± 2). Cough (73%) and unilateral reduced breath sound (51%) were the most common clinical symptom and clinical sign. The most frequent localization was the right main bronchus (43%). The foreign bodies retrieved were vegetable (83%), of which peanut was the most common. Chest radiographs were normal in 25%. The mean duration of hospitalization was 5days (± 2.9). Complications such as pneumothorax were seen in two cases. Foreign body inhalation represents a true pediatric emergency and still a challenge in clinical practice. The best way to manage it is an early diagnosis and removal by fully trained staff.

Retrospective Indicators of Foreign Body Aspiration in Children of the Surgery Department of the Osh Interregional Children's Clinical Hospital

The article provides the results of a retrospective analysis of medical documentation (medical history form No. 003/Y) in 245 children with foreign bodies of the respiratory tract who were hospitalized at the Osh Interregional Clinical Children’s Hospital from 2012 to 2016. According to localization, foreign bodies in the respiratory tract were mostly in 56 (22.85%) patients — in the right main bronchus, 32 (13.1%) children — in the left main bronchus.

Delayed presentation of traumatic hepatothorax: An anesthetic and surgical perspective

: Traumatic diaphragmatic hernia is an uncommon sequela of blunt and penetrating trauma. It is estimated that 0.8–1.6% of patients with blunt trauma develop diaphragmatic rupture. However, the diagnosis of this condition is often overlooked, with right-sided hernias missed more frequently than left-sided hernias. Early diagnosis and repair are essential to prevent future complications such as strangulation and ischemia of intra-abdominal organs, lung collapse, and cardiovascular demise.: A 17-year-old male (180 cm; 86 kg) with no comorbidities presented to the emergency department (ED) following a high-velocity, unrestricted, rear-ended motor vehicle crash (MVC). The patient was intubated and hemodynamically stabilized in the ED, with planned surgical exploration of the abdomen. Six days following the accident, the patient was extubated; he became increasingly hypoxic and tachypneic over the next day. A CT of the chest and pelvis was ordered, confirming the diagnosis of a post-traumatic right-sided diaphragmatic hernia. An exploratory laparotomy was scheduled. Difficulties with ventilation were encountered due to suspected lung compression by the liver and movement of the endotracheal tube into the right main lung bronchus. : Traumatic diaphragmatic hernia should be considered in all patients presenting with abdominal trauma and should be suspected if respiratory distress arises during the patient’s clinical course. The recommended anesthetic approach is rapid sequence intubation with a cardiovascular-stable agent like etomidate and gastric decompression. Difficulties with intubation and ventilation should be anticipated due to the presence of the visceral organs within the thoracic cavity.

Extracellular acidification attenuates bronchial contraction via an autocrine activation of EP2 receptor: Its diminishment in murine experimental asthma

PurposeExtracellular acidification is a major component of tissue inflammation, including airway inflammation in asthmatics. However, its physiological/pathophysiological significance in bronchial function is not fully understood. Currently, the functional role of extracellular acidification on bronchial contraction was explored. MethodsLeft main bronchi were isolated from male BALB/c mice. Epithelium-removed tissues were exposed to acidic pH under submaximal contraction induced by 10−5 M acetylcholine in the presence or absence of a COX inhibitor indomethacin (10−6 M). Effects of AH6809 (10−6 M, an EP2 receptor antagonist), BW A868C (10−7 M, a DP receptor antagonist) and CAY10441 (3×10−6 M, an IP receptor antagonist) on the acidification-induced change in tension were determined. The release of prostaglandin E2 (PGE2) from epithelium-denuded tissues in response to acidic pH was assessed using an ELISA. ResultsIn the bronchi stimulated with acetylcholine, change in the extracellular pH from 7.4 to 6.8 caused a transient augmentation of contraction followed by a sustained relaxing response. The latter inhibitory response was abolished by indomethacin and AH6809 but not by BW A868C or CAY10441. Both indomethacin and AH6809 significantly increased potency and efficacy of acetylcholine at pH 6.8. Stimulation with low pH caused an increase in PGE2 release from epithelium-denuded bronchi. Interestingly, the acidic pH-induced bronchial relaxation was significantly reduced in a murine asthma model that had a bronchial hyperresponsiveness to acetylcholine. ConclusionTaken together, extracellular acidification could inhibit the bronchial contraction via autocrine activation of EP2 receptors. The diminished acidic pH-mediated inhibition of bronchial tone may contribute to excessive bronchoconstriction in inflamed airways such as asthma.

Combined resection of lung cancer and thoracic aortic wall with simultaneous thoracic aortic endografting: a case report

BackgroundCombined resection of lung cancer and the thoracic aortic wall with thoracic aortic endografting has been reported. However, whether the resection and endografting should be performed simultaneously or in two steps remains controversial.Case presentationA 68-year-old man was referred to our hospital because of left chest pain. Chest contrast-enhanced computed tomography revealed a huge tumor of the left lower lung lobe, and invasion to the aortic wall was suspected. Bronchoscopic examination was performed, revealing squamous cell carcinoma with a programmed death ligand 1 expression level of 90%. The clinical stage was T4N0M0 stage 3A. After neoadjuvant chemotherapy and radiotherapy, we performed one-stage surgery with the patient in the right lateral decubitus position and the left inguinal region exposed for femoral vessel isolation. Posterolateral thoracotomy was performed with making a latissimus dorsi muscle flap. The pulmonary artery, vein, and left lower bronchus were cut with a stapler. After hilar isolation, we evaluated the involvement of the descending aorta and marked the area of the involved aortic wall by a surgical clip. Using the left femoral artery approach, a GORE TAG conformable thoracic stent graft was delivered to the descending aorta. After thoracic aortic endografting, the involved aortic wall was resected and the left lower lobe of the lung and resected aortic wall were resected en bloc. The adventitial defect was covered by the latissimus dorsi muscle flap. The operating time was 474 min, and the blood loss volume was 330 mL. The postoperative pathological diagnosis was adenocarcinoma with an epidermal growth factor receptor mutation of exon 19 deletion. The residual viable tumor was 7 mm in diameter and close to the resected aortic wall. The patient’s postoperative course was uneventful. Five days after surgery, chest contrast-enhanced computed tomography revealed no endoleak or stent migration. Three months after surgery, he was alive with neither recurrence nor stent graft-related complications.ConclusionsOne-stage surgery involving combined resection of lung cancer and the thoracic aortic wall with simultaneous thoracic aortic endografting in the right lateral decubitus position with the left inguinal region exposed is safe and acceptable.

Bronchoscopic removal of an aspirated vegetal foreign body in a small Münsterländer

Foreign bodies are common in pets and may cause vague clinical signs. One of the locations a foreign body can be found is the bronchial region. The foreign body itself, but also secondary inflammation and infection can lead to severe tissue reactions. Bronchoscopy is a useful diagnostic imaging tool, due to its diagnostic ability and therapeutic possibilities to directly remove foreign bodies. In the present case, a small Münsterländer was presented with a one-week existing productive cough. The dog inhaled a wheat spike into the airways, subsequently causing the development of secondary inflammation and infection. Through bronchoscopy, the foreign body was located in the left mainstem bronchus and removed successfully with a special forceps.

Unusual cause of the left main bronchus stenosis: relapsing polychondritis.

Relapsing polychondritis is a rare disease that causes inflammation and destruction of cartilage and connective tissue. It can be associated with other autoimmune rheumatologic and hematologic diseases. Herein, we report a 38-year-old male patient with relapsing polychondritis and diffuse stenosis of the left main bronchus.