Cancer Res Treat.  2015 Jul;47(3):544-548. 10.4143/crt.2013.220.

Usefulness of Digital Tomosynthesis for the Detection of Airway Obstruction: A Case Report of Bronchial Carcinosarcoma

• Park SJ
• Choo JY
• Lee KY
• Kim JH
• Choi JW
• Yeom SK
• Kim BH

• KMID: 2148507
• DOI: http://doi.org/10.4143/crt.2013.220

Abstract

Bronchial carcinosarcoma is a very rare malignant tumor that is composed of carcinomatous and sarcomatous elements. We describe the first case in which digital tomosynthesis was useful for the evaluation of airway obstruction by bronchial carcinosarcoma that was overlooked on initial chest radiography.

Keyword

Bronchopulmonary; Carcinosarcoma; Digital tomosynthesis; Radiography; Radiation exposure; Computed tomography; Airway obstruction

MeSH Terms

Airway Obstruction*
Carcinosarcoma*
Radiography
Thorax

Figure

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  Fig. 1. Initial chest radiography. The endobronchial mass with left upper lobar bronchial narrowing was overlooked on the initial chest radiography.

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  Fig. 2. Digital tomosynthesis (DTS). (A) DTS reveals a lobulating contoured endobronchial lesion nearly obstructing the left main bronchus. (B) The tumor extends to the left upper lobar bronchus and the left lower lobar bronchus. However, the superior segmental bronchus is not obliterated on the last image with patent three holes (arrows). The extent and margins of the endobronchial tumor are well demarcated on serial anterior-to-posterior coronal images from the DTS. The yellow overlay and gray patent bronchi are demonstrated in the lower images.

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  Fig. 3. On the computed tomography images, a mildly enhanced lesion with finger-like appearance was noted along the left main bronchus extending to the upper and lower lobar bronchi, as suspected on digital tomosynthesis.

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  Fig. 4. Bronchoscopic finding. Subsequent bronchoscopy revealed a mass lesion almost completely occluding the left main bronchus at a site 4 cm below the carina and protruding to the endobronchial space. Bronchoscopic biopsy was performed.

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  Fig. 5. Pathologic finding demonstrated sarcomatous (arrow) and carcinomatous (arrowhead) components (H&E staining, ×200).

Reference

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