Rhinosporidiosis of the bronchus.
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A case of endobronchial granular cell tumor and an adenocarcinoma in the same lobe of the lung are presented. A review of the literature documents 2 cases where there was coexistence of a bronchogenic carcinoma and a granular cell tumor. The different theories regarding the origin of granular cell tumors are considered. The treatment of choice would be that indicated for the carcinoma irrespective of the granular cell tumor.
Hypercalcemia was found in a patient with an endobronchial granular cell tumor. To the best of our knowledge, the association of hypercalcemia and granular cell tumor has not been previously reported in the literature. Resection of the tumor resulted in the return of the serum calcium levels to normal. Investigation of the metabolic status of the patient suggested that the tumor was not producing parathormone.
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Primary leiomyosarcoma of the respiratory tract is a very rare malignancy, especially in childhood, with only 15 cases in patients under 16 years old having been reported. In the present case, the survival period from the onset of symptoms has been over 7 years, despite incomplete resection. Based on the 15 published cases, the prognosis is poorer when the tumor is unresected or incompletely resected, but under favorable circumstances, prolonged survival is possible.
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Biotransformation of formaldehyde to formic acid was studied to investigate the capacity of human bronchial epithelial cells to detoxicate formaldehyde. Normal human bronchial explants and normal primary bronchial epithelial cells were grown in medium containing 0.5 to 5 mM formaldehyde for up to 48 h. Formic acid was quantitated by analytical isotachophoresis. Explants were cultured with up to 5 mM formaldehyde for 48 h with approximately linear turnover, but at 5 mM the cells showed reduced biotransformation relative to the lower concentrations. The mean K(m) values for explants were 1.4 and 5.1 mM for cells and the mean V(max) values were 3.3 nmol/mg protein.min for the explants and 6.1 nmol/mg protein.min for the cells. By using the same technique with hepatocytes we found K(m) 1.25 mM and V(max) 4.2 nmol/mg protein.min, indicating that human bronchial epithelium cells have formaldehyde biotransforming activity similar to that of hepatocytes. Our results indicate that human bronchial epithelial cells oxidize formaldehyde at a relatively fast rate at concentrations up to 3 mM formaldehyde in the medium over a period up to 48 h.
Studies in small non-cartilaginous airways suggest that the cross sectional area of the airway wall (comprising the smooth muscle and mucosa) is unaltered during the contraction-relaxation cycle produced by bronchial provocation. In the present study we examined whether the wall area of large cartilaginous bronchi remained constant during bronchoconstriction produced by acetylcholine (ACh, 10(-4)-10(-2)M), and if not the effect of this on the narrowing of the bronchial lumen. Narrowing of the lumen and adventitia of bronchial segments, 3.6 mm id from pigs, was simultaneously recorded using endoscopy and video imaging of the airway lumen. Concurrently, the shortening of the smooth muscle was estimated morphometrically from the same bronchi fixed during muscle contraction. In individual bronchi, ACh produced from 5 to 60% shortening of the smooth muscle, which caused up to 64% narrowing of the bronchial lumen, but only approximately 10% narrowing of the adventitia. Lumen narrowing was greater than predicted. Morphological assessment showed a doubling of the area between the smooth muscle and the cartilage, in response to maximum smooth muscle contraction by ACh. In contrast the area of the smooth muscle and mucosa did not change. Similar changes in bronchial morphology were produced in whole lung slices, incubated in ACh or histamine. We conclude that the inner airway wall uncouples from the outer wall during muscle contraction and that this increases the narrowing of the airway lumen relative to the adventitia.