Obliterative lower airway lesions in childhood: Bronchoscopic diagnosis and clinical spectrum
- 4 March 2013
- journal article
- case report
- Published by Wiley in Pediatric Pulmonology
- Vol. 49 (3), E27-34
- https://doi.org/10.1002/ppul.22775
Abstract
Previous reports have described structural airway abnormalities in children with non‐cystic fibrosis chronic suppurative lung disease as well as obliterative membranes in the major bronchi of cystic fibrosis patients. The putative paradigm proposed in the evolution of these membranes invokes intense inflammation resulting in granulation tissue and neovascularization with the formation of pyogenic granuloma and eventually fibrosis. Our series of four cases widens the spectrum of conditions that may be conducive to large airway obliteration to include non‐suppurative chronic infections and possibly immunosuppression. Obliteration of lumina in proximal and distal airways was visualized on bronchoscopy, the latter by the use of the ultrathin bronchoscopes. An attempt at invasive intervention by transbronchial breaching of the obstruction was unsuccessful in three cases, and in one case, the obliterative process resolved spontaneously and without any radiologic trace, presumably by resorption or rupture or through development of collateral ventilation. This series highlights the use of bronchoscopy for diagnosis and occasionally for therapeutic intervention in hitherto little recognized obliterative airway lesions. These acquired obliterative lesions should be considered in the evaluation of patients with isolated non‐resolving pulmonary infiltrates or other conditions in which bronchial and bronchiolar patency may be impaired. Pediatr Pulmonol.Keywords
Funding Information
- none reported
This publication has 17 references indexed in Scilit:
- Re: Membranous obliterative bronchitis: A proposed unifying modelPediatric Pulmonology, 2006
- Bronchial hyperresponsiveness, atopy, and bronchoalveolar lavage eosinophils in persistent middle lobe syndromePediatric Pulmonology, 2006
- Membranous Obliterative Bronchitis: A Proposed Unifying ModelPediatric Pulmonology, 2006
- The Role of Timely Intervention in Middle Lobe Syndrome in ChildrenChest, 2005
- Bronchoscopic findings in children with non-cystic fibrosis chronic suppurative lung diseaseThorax, 2002
- Obliterative bronchiolitis: varying presentations and clinicopathological correlationEuropean Respiratory Journal, 2002
- Lung infections bullet 4: Pathogenesis of lower respiratory tract infections due to Chlamydia, Mycoplasma, Legionella and virusesThorax, 1998
- Post-infectious bronchiolitis obliterans: clinical, radiological and pulmonary function sequelaePediatric Radiology, 1998
- Apoptosis during wound healing, fibrocontractive diseases and vascular wall injuryThe International Journal of Biochemistry & Cell Biology, 1997
- Endobronchial Tuberculosis RevisitedChest, 1986