Tuberc Respir Dis.  2010 Apr;68(4):231-235.

A Case of Node-bronchial Fistula by Non-small Cell Lung Cancer

• Kim SW
• Kim HK
• Jeun SJ
• Park HS
• Jang JH
• Lee JH
• Ryu YJ
• Sim SS
• Chun EM

Abstract

Lymphadenopathy in the thoracic cavity is frequently caused by inflammatory diseases. In very rare cases, the node-bronchial fistula has been reported to be the cause of complications of pulmonary tuberculosis. A male patient with necrotizing pneumonia and mediastinal lymph node enlargements identified by chest computed tomography was also found to have a node-bronchial fistula caused by lung cancer. The patient was treated for tuberculosis with pneumonia for one week before a definitive diagnosis was made. A further investigation revealed him to have non-small cell lung cancer (NSCLC, adenocarcinoma) and multiple mediastinal lymphadenopathies accompanied with the node-bronchial fistula. We report this specific case that had been previously treated for tuberculosis but was later revealed to be NSCLC accompanied with a node-bronchial fistula.

Keyword

Bronchial Fistula; Lung Neoplasms; Lymph Nodes

MeSH Terms

Bronchial Fistula
Carcinoma, Non-Small-Cell Lung
Fistula
Humans
Lung Neoplasms
Lymph Nodes
Lymphatic Diseases
Male
Pneumonia
Thoracic Cavity
Thorax
Tuberculosis
Tuberculosis, Pulmonary

Figure

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  Figure 1 Chest X-ray on admission showed multiple consolidations in right upper lung zone and left lingular lobe.

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  Figure 2 Chest CT scan revealed subcarinal lymph node enlargement with air bubbles (possible node-bronchial fistula between airway and subcarinal lymph node). Multiple necrotic lymph nodes enlargement were seen in mediastium, both hilar, retrosternal and lower cervical area.

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  Figure 3 Chest CT scan during follow up periods revealed that the size of lymph node at subcarinal area was decreased but another lymph nodes showed variable response.

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  Figure 4 Chest X-ray on hospital day 32 showed improvement of consolidation in both lung fields.

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