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PubMed1994

[Segmentectomy and bronchoplasty for early stage squamous cell carcinoma of the segmental bronchus].

Five cases with hilar type early stage squamous cell carcinoma of the segmental bronchi underwent segmentectomy and bronchoplasty. All were males and the ages with sixties. Locations of early stage lung cancer were the apical bronchus of the right lower lobe (B6) in one patient, the intermediate-lower lobe bronchus in one, the anterior bronchus of the left upper lobe (B3) in two and the lower division bronchus (B4+5) in one. All were diagnosed as early stage squamous cell carcinoma by preoperative bronchoscopic examination. The segments resected were the right S6 in two, left S1+2+3 in one, left S4+5 in one and left S3 in one. There was no postoperative complications related to bronchial anastomosis. One patient died of secondary primary lung cancer 3 years after operation. While, four patients are alive and well one, 6, 12 and 46 months after surgery. Sleeve segmentectomy for the patients with early stage squamous cell carcinoma of the segmental bronchus is a curative operation with preserving pulmonary function.

Aged↗
PubMed1998

Bronchial wall schwannoma removed by sleeve resection of the right stem bronchus without lung resection.

A 28-year-old man presented with a bronchial wall schwannoma occurring in the right main to the intermediate bronchus. The tumor was resected en-bloc with the stem bronchi without pulmonary resection. Airway reconstruction consisted of an end-to-end anastomosis of the intermedius bronchus to the right main bronchus, and an end-to-side anastomosis of the right upper lobe bronchus to the lateral wall of the trachea. Postoperative course was uneventful. Bronchoplastic procedure with preservation of the lung parenchyma seems to be the technique of choice for benign tumors occurring intramurally in the stem bronchus.

Adult↗
PubMed1997

The bridging bronchus. Successful diagnosis and repair.

Anomalies of bronchial branching are infrequent and may be difficult to diagnose. The bridging bronchus is a rarely reported anomaly that may not be as sporadic as once thought. We describe an infant with respiratory distress whose right middle and lower lobes were supplied by a bridging bronchus arising from the left main bronchus. The airway anatomy was defined using flexible and rigid bronchoscopy and helical computed tomographic scanning, enabling successful surgical repair. We review current literature on the bridging bronchus as well as the possible embryological basis for this defect.

Bronchi↗
PubMed1998

Braided bronchus: a previously undescribed airway anomaly.

Infants with congenital heart disease frequently experience recurrent atelectasis, in many cases associated with anomalous branching of the bronchial tree. The bridging bronchus has been well described and has been associated with both left-sided obstructive lesions and a sling-like left pulmonary artery. We describe a similar, though distinct airway anomaly, the "braided bronchus," associated with a bridging bronchus in a child with coarctation of the aorta and recurrent atelectasis. Methods used to delineate the "braided bronchus" are described.

Aortic Coarctation↗
PubMed1979

Mucoepidermoid carcinoma of the bronchus: an electron microscopic study of the low grade and the high grade variants.

Two cases of mucoepidermoid carcinoma of the bronchus--one a low grade tumor and the other a high grade tumor--are presented with findings by light and electron microscopy. This represents the first report of the ultrastructure of mucoepidermoid carcinoma of the bronchus and demonstrates the ultrastructural similarities between the low grade exophytic tumor confined to the bronchus and the high grade infiltrating tumor with lymph node and pulmonary metastases. The ultrastructural features are similar to those described for mucoepidermoid carcinoma of the salivary gland and are consistent with the proposed origin of the tumor from the submucosal bronchial gland duct. These two cases and a review of previously reported cases indicate that, analogous to mucoepidermoid carcinoma of the salivary glands, mucoepidermoid carcinoma of the bronchus may occur as either a low grade or high grade variant which can be identified on the basis of growth characteristics and histologic features.

Adult↗
PubMed1994

Endoscopic criteria of early squamous cell carcinoma of the bronchus.

BACKGROUND: Early lung cancer, not extending beyond the bronchial cartilaginous layer without regional lymph node involvement is considered curable by endoscopic laser therapy or limited surgery. The endoscopic criteria for early squamous cell carcinoma of the bronchus, however, have not yet been determined. METHODS: For 44 resected lesions of roentgenographically occult bronchogenic squamous cell carcinomas, the relationship between endoscopic findings and the degree of histologic extent of tumor was examined. RESULTS: The lesions were divided into three types: polypoid or nodular (PN), flatly spreading (FS), and mixed. Thirty-three lesions arising from the central bronchus included 7, 19, and 7 of the PN, FS, and mixed types, respectively. In the central lesions, the degree of transmural invasion and the greatest dimension correlated, but the degree of intramural invasion of PN-type lesions was higher than that of the FS type. The PN-type lesions smaller than 10 mm and the FS type smaller than 15 mm in greatest dimension were found within the cartilaginous layer without regional lymph node involvement. All lesions of the mixed type were larger than 20 mm. Three of the lesions larger than 20 mm had regional lymph node involvement. All 11 lesions originating in the peripheral bronchus were of the FS type, and a lesion of only 5 mm in greatest dimension had extracartilaginous invasion. CONCLUSIONS: The endoscopic criteria of early squamous cell carcinoma of the bronchus may be applied to central PN lesions smaller than 10 mm and central FS lesions less than 15 mm in greatest dimension. Any lesions of mixed type should be excluded from the criteria.

Aged↗
PubMed2002

Primary bronchopulmonary leiomyosarcoma of the left main bronchus in a child presenting with wheezing and atelectasis of the left lung.

Primary lung tumors are rare in children, and primary bronchopulmonary leiomyosarcomas are very rare in children, with only 10 cases reported in the English-language literature. We report on the eleventh case of primary bronchopulmonary leiomyosarcoma in a child, and it is the first case in Taiwan, and also in Asia. In addition, this is the second case of this tumor arising in the left main bronchus. Before the present case, there were only 2 cases of this tumor in the main bronchus: one was in the right main-stem bronchus, and the other in the left-stem main bronchus. Ours is the second case showing pleural effusion. Chest roentgenogram and bronchoscopy are helpful in the diagnosis of primary bronchopulmonary tumors, but a definitive diagnosis can only be made by biopsy. The tumor is potentially curable if total excision is possible; irradiation has little therapeutic value, and early excision offers the only hope of cure. The child is alive and well 19 months after pneumonectomy, without having received radiotherapy or chemotherapy.

Asthma↗
PubMed2004

Evaluation of tracheobronchial anomalies in children using low-dose multidetector CT: report of a 13-year-old boy with a tracheal bronchus and recurrent pulmonary infections.

Tracheobronchial anomalies in children may be associated with recurrent episodes of pulmonary infections and symptoms of recurrent or persistent airway obstruction. Diagnosis by conventional imaging may be difficult. Multidetector computed tomography (MDCT) offers the possibility to generate a virtual three-dimensional bronchoscopy, thus enabling detailed overview of the tracheobronchial system. We report on a 13-year old boy, admitted to hospital after recurrent episodes of bronchial infections. Functional studies showed airway obstruction with no response to bronchodilators. A chest radiograph was normal. Flexible bronchoscopy revealed tracheobroncho malacia of the distal trachea and the right main bronchus. The ostium of an accessory right-sided tracheal bronchus, which could not be entered by the endoscope, was also detected. MDCT using a low-dose protocol was performed on a four-section scanner (Somatom Volume Zoom, Siemens, Erlangen, Germany). A three-dimensional virtual bronchoscopy based on surface rendering was generated, which confirmed moderate narrowing of the trachea and right main bronchus. Furthermore, an accessory and stenotic tracheal bronchus including poststenotic segments, ventilating parts of the right upper lobe, could be clearly visualized. MDCT can be a valuable instrument in the diagnostic pathway of assessing tracheobronchial anomalies in children, including visualization of poststenotic bronchial structures. The use of low-dose protocols provides adequate image quality to perform virtual bronchoscopy, thus reducing administered radiation to a tolerable amount.

Adolescent↗
PubMed1987

Endoscopic sealing of infected bronchus stump fistulae with fibrin following lung resections. Experimental and clinical experience.

Bronchus stump insufficiency following lung resection, with an average incidence of 4%, is a serious complication which carries a mortality of up to 90%. Operative transthoracic approaches have been largely unsatisfactory because of the high operative risk and rapidly spreading infection. In an experimental study on 18 pigs, endoscopic occlusion of infected bronchus stump fistulae was achieved with fibrin sealant (1 ml, 500 units/ml thrombin, 3500 units/ml aprotinin) applied via a flexible bronchoscope. During autopsy, all bronchus stump fistulae were found to have healed after the second postoperative week. Transitory local abscesses of the pleura could be prevented by high-dose systemic antibiotic therapy for 5 postoperative days but not by antibiotics added to the fibrin sealant. This endoscopic method has already been performed successfully in 3 clinical cases; additional sclerotherapy with (2-3 ml Ethoxysclerol applied around the fistula orifice was carried out before fibrin sealing to stimulate fibrosis. Endoscopic controls demonstrated fistula closure by granulation tissue after 2 weeks. This procedure could become the method of choice for infected postoperative fistulae of the bronchus stump and should be attempted in any case before operative approaches are considered.

Animals↗
PubMed2001

"Porcine bronchus" diagnosed in neonatal period.

"Porcine bronchus" is a right upper lobe bronchus arising directly from the trachea. This is an infrequent congenital abnormality and it usually represents the displaced origin of a normal bronchus. We herewith report a case of a child who was diagnosed to have tracheal bronchus in neonatal period and followed subsequently until 13 months of age.

Bronchi↗
PubMed1999

Accessory cardiac bronchus: 3D CT demonstration in nine cases.

Accessory cardiac bronchus (ACB) has been described mainly as isolated case reports in the literature. We report nine consecutive cases of ACB, which occurred in five males and four females and were detected in 11,159 routine spiral CT examinations of the chest, performed between 1994 and 1998. Frequency of the anomaly was 0.08 %. Accessory cardiac bronchus originated from the intermediate bronchus in eight cases and from the right main bronchus in one case. Mean largest diameter of ACB was 8.7 mm (range 4.0-13.8 mm) and mean length was 11.9 mm (range 4.2-23.4 mm). An abnormal pulmonary artery was observed in one case. Six bronchi presented with a blind distal extremity and three showed a ventilated lobulus with a mean largest diameter of 37.5 mm (range 18.6-62.0 mm). All ACBs were documented by 3D shaded-surface display (SSD) and virtual endobronchial navigation, which may facilitate the diagnosis. The literature was reviewed.

Adult↗
PubMed1996

Results of resection of T3 non-small cell lung cancer invading the mediastinum or main bronchus.

BACKGROUND: T3 tumors can be divided into several subgroups. Surgical treatment of T3 tumors with chest wall invasion results in good survival. This study shows the results of resection of T3 non-small cell tumors located in the main bronchus or with invasion of mediastinal structures. METHODS: From 1977 through 1993, 108 patients underwent resection for primary non-small cell carcinomas located in the main bronchus or with invasion of mediastinal structures. A complete resection was performed in 70 patients (64.8%). Actuarial survival time was estimated and risk factors for late death were identified. RESULTS: Overall hospital mortality was 8.3%. All deaths followed pneumonectomy. Mean 5-year survival was 29% for all hospital survivors, 35% for patients with complete resection, and 18% for patients with incomplete resection (p = 0.03). In patients with complete resection, mean 5-year survival was 45% for N0 patients and 37% for N1 patients. There were no 5-year survivors in the group of N2 patients. The mean 5-year survival was greater (but not statistically significantly greater) in patients with tumors located in the main bronchus (40%) than in patients with tumors with invasion of mediastinal structures (25%) (p > 0.05). Histology, tumor spill, age, sex, and type of operative procedure were not significant prognostic factors. CONCLUSIONS: Patients with tumors located in the main bronchus have a better survival than patients with invasion of the mediastinal structures. Pneumonectomy increases hospital mortality. Incompleteness of resection and mediastinal lymph node involvement influence survival significantly.

Adult↗
PubMed1984

Conjugation of 1-naphthol by human bronchus and bronchoscopy samples.

Human bronchus, in short-term explant culture, metabolized 1-naphthol to both its sulphate ester and glucuronic acid conjugates. At low concentrations of 1-naphthol (20 microM), more 1-naphthyl sulphate than 1-naphthyl-beta-D-glucuronide was formed. At similar substrate concentrations, short-term explant cultures of both bronchus without cartilage and bronchoscopy samples, which consisted largely of bronchial epithelium, formed predominantly 1-naphthyl-beta-D-glucuronide. Thus cartilage, which alone did not significantly metabolize 1-naphthol, may in some way influence the metabolism of 1-naphthol by intact bronchus. A large inter-individual variation was observed in the conjugation of 1-naphthol by cultured human bronchus. Such variations in the conjugation of chemicals may be of importance in determining individual susceptibility to chemically induced damage.

Bronchi↗
PubMed1987

Relative potencies of neurokinins in guinea pig trachea and human bronchus.

The three endogenous neurokinins, substance P (SP), neurokinin A (NKA) and neurokinin B (NKB), as well as NKA-(4-10), carbachol, acetylcholine and histamine, were tested in guinea pig tracheae and human bronchi in order to compare the activities of peptides and non-peptide agents and to characterize the neurokinin receptors by means of agonists. Neurokinin A and NKA-(4-10) were potent stimulants of the two preparations: pD2 values for NKA-(4-10) averaged 8.62 in the guinea pig trachea and 7.50 in the human bronchus. The rank order of potency of neurokinins was NKA-(4-10) greater than NKA greater than SP greater than NKB in the human bronchus and NKA-(4-10) greater than NKA greater than NKB greater than SP in the guinea pig trachea. SP was 2-3 orders of magnitude less active than NKA and appears to be a partial agonist. NKB is inactive on the human bronchus. Compared to non-peptide agents, NKA had an affinity 2-3 orders of magnitude greater than acetylcholine and histamine but produced only 75-80% of the maximal effect of acetylcholine. The present results indicate that neurokinins contract the human bronchus by activating a NK-A receptor type which is more sensitive to NKA than to SP and is insensitive to NKB. The guinea pig trachea appears to be a complex preparation containing not only NK-A but also other neurokinin receptors.

Animals↗
PubMed1990

Further studies on the response of the guinea-pig isolated bronchus to endothelins and sarafotoxin S6b.

Endothelin-1 (ET-1), endothelin-3 (ET-3) and sarafotoxin S6b (SRFTX) produced a concentration-dependent contraction of the guinea-pig isolated bronchus. In untreated preparations, SRFTX was about 10 times more potent than ET-1 or ET-3 and produced a greater maximal effect. Mechanical removal of the bronchial epithelium (rubbing) or the addition of indomethacin (5 microM) increased the potency of all peptides, ET-3 being enhanced more than ET-1 or SRFTX. Further, the activity of ET-3 was enhanced by a mixture of peptidase inhibitors (thiorphan, captopril, bestatin, 1 microM each). When the three potentiating factors were combined (rubbed bronchi in presence of indomethacin and peptidase inhibitors), the following order of potency was found, ET-3 congruent to SRTFX greater than ET-1. For comparison, the activity of the three peptides was also studied in the rubbed rat isolated aorta in the presence of indomethacin and peptidase inhibitors and the following rank order of potency was found: ET-1 greater than SRFTX greater than ET-3. When the activity of the peptides was compared in these two preparations, ET-1 was 4 times more potent in the aorta than in the bronchus, while SRFTX and ET-3 were 8.7 and 133 times more potent in the bronchus than the aorta, respectively. These findings indicate that, in the guinea-pig bronchus, the contractile activity of these peptides is attenuated by the concomitant production of epithelium-derived relaxant factor(s), prostanoid production via the cyclooxygenase pathway and, possibly, enzymatic inactivation of added peptides. Further, the existence of multiple receptors mediating the contractile response to these peptides is suggested.

Animals↗
PubMed1987

Comparative effects of platelet activating factor, leukotriene D4 and histamine on guinea pig trachea, bronchus and lung parenchyma.

The myotropic effect of platelet activating factor (PAF), leukotriene D4 (LTD4) and histamine were compared on guinea pig pulmonary tissues. The initial administration of PAF induced a contraction of strips of trachea, bronchus and lung parenchyma. However subsequent injections were characterized by relaxation of trachea and bronchus and a highly reduced (if any) contraction of the parenchyma. The three tissues of the guinea pig respiratory system contracted strongly to leukotriene D4 and histamine. Indomethacin blocked PAF-induced relaxation of the trachea and bronchus and reduced the contraction of the lung parenchyma. The injection of PAF in the pulmonary circulation stimulated the release of substance(s) causing the contraction of the trachea, bronchus and parenchyma. This study suggests that PAF is not a direct agonist of bronchoconstriction.

Airway Resistance↗
PubMedDate not supplied

The positive bronchus sign in patients with known lung cancer.

The positive bronchus sign is the CT finding of a bronchus leading to or contained within the primary mass. A prospective study was performed for the purpose of establishing the correlation between the above sign on CT and the visual and pathological findings on bronchoscopy. The predictive value for the positive bronchus sign was found to be 94% and that of the negative bronchus sign 62%. CT is useful in predicting the likelihood of subsequent bronchoscopy providing positive results.

Adenocarcinoma↗
PubMed2002

Tracheobronchoplasty for resection of lung cancer arising from a tracheal bronchus.

Tracheal bronchus is a rare anomoly wherein a bronchus arises directly from the trachea and supplies the right upper lobe. We had a case of lung cancer arising from a tracheal bronchus with invasion into the trachea. Tracheobronchoplasty was needed for complete resection of the tumor. Because of the anatomical characteristics of the tracheal bronchus, special surgical techniques for resection of the neoplasm were needed.

Bronchi↗