This patient was a 47-year female who underwent carinal resection and reconstruction because of left main bronchial mucoepidermoid carcinoma. She underwent four cycles chemotherapy when recovering from surgery because of subcarinal lymph node metastasis. However, the patient suffered from recurred productive cough and dyspnea during chemotherapy. Bronchoscopic assessment revealed stenosis at the reconstructed carina and left main bronchus five months after surgery. The granulation tissues of the left main bronchus showed no evidence of cancer recurrence. After repeated bronchoscopic resection of granulation tissue combined with bronchial stent placement, the left main bronchial stenosis gradually worsened with granulation tissue growth. Three acid-fast bacilli were found in the granulation tissue harvested ten months after surgery. The reason of postoperative bronchostenosis was confirmed as endobronchial tuberculosis, and antitubercular agents were added. Unfortunately, she had persistent left main bronchostenosis due to irreversible destruction and left pulmonary atelectasis thereafter. Therefore, for the recurring anastomotic granulomas after tracheobronchial reconstruction, the possibility of tuberculosis infection should be considered.
Citation：
FAN Qiao, GUO Chenglin, PU Qiang, MEI Jiandong. Anastomotic tuberculosis after carinal resection and reconstruction: A case report. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(10): 1255-1257. doi: 10.7507/1007-4848.202107092
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Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
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- 2. Gonfiotti A, Jaus MO, Barale D, et al. Carinal resection. Thorac Surg Clin, 2014, 24(4): 477-484.
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- 4. Gonzalez-Rivas D, Garcia A, Chen C, et al. Technical aspects of uniportal video-assisted thoracoscopic double sleeve bronchovascular resections. Eur J Cardiothorac Surg, 2020, 58(Suppl_1): i14-i22.
- 5. Qiu T, Zhao Y, Xuan Y, et al. Robotic sleeve lobectomy for centrally located non-small cell lung cancer: A propensity score-weighted comparison with thoracoscopic and open surgery. J Thorac Cardiovasc Surg, 2019, S0022-5223(19): 33072-33077.
- 6. Liu L, Mei J, Pu Q, et al. Thoracoscopic bronchovascular double sleeve lobectomy for non-small-cell lung cancer. Eur J Cardiothorac Surg, 2014, 46(3): 493-495.
- 7. Santosham R, Deslauriers J. Tuberculosis and other granulomatous diseases of the airway. Thorac Surg Clin, 2018, 28(2): 155-161.
