Squamous Cell Lung Cancer That Developed into an Abscess After Transbronchial Biopsy and the Effectiveness of Surgical Resection : a Case Report

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  • Takeoka Sawa
    Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
  • Okamoto Norio
    Department of Respiratory Endoscopy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
  • Osa Akio
    Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
  • Shiroyama Takayuki
    Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
  • Tamiya Motohiro
    Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
  • Suzuki Hidekazu
    Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
  • Hirashima Tomonori
    Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
  • Kawase Ichiro
    Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases
  • Ota Mitsunori
    Department of Respiratory Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases

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Other Title
  • 経気管支生検後に肺膿瘍を併発し外科的切除により救命し得た肺扁平上皮癌の1例

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Abstract

Background. Established precautions or treatment approaches for lung abscesses that occur as a complication of transbronchial biopsy (TBB) have not been reported. Case. A 77-year-old man presented with cough. Computed tomography of the chest showed an aerated mass in the right upper lobe and right hilar regions, mediastinal lymphadenopathy, and a narrowed right superior lobe bronchus. We diagnosed lung cancer based on the TBB findings. The patient became febrile the day after the TBB and was treated with antimicrobials. However, the treatment effects were limited because the mass had partly developed into an abscess. As the cavity inside the mass grew larger, he became to present with severe hemoptysis. He underwent surgery to remove the mass, which was successful. Conclusion. Lung abscesses that are a complication of TBB of a tumor, especially those with air spaces or a narrowed bronchus, should be treated carefully. We propose that the avoidance of excessive biopsies or the brushing of this type of tumor are effective precautions. In addition, surgery to remove the mass should be actively considered in addition to the administration of antimicrobials if the abscess becomes enlarged.

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