Carcinoid and adenoid cystic carcinoma of the bronchus

A careful study of the pharmacology of individual carcinoid tumors may increase our knowledge of such tumors. It may also be rewarding in other fields because of the biological interaction of kinins, serotonin, histamine, prostaglandins, and other agents. The poor correlation of signs and symptoms of the carcinoid syndrome with chemical assay may be due to lack of knowledge. The carcinoid syndrome must be considered a spectrum [130], and its diagnostic criteria should be liberalized.     

Adenoid cystic carcinoma of the left main bronchus mimicking MacLeod''s syndrome.

A 15 year old girl who was labelled as having MacLeod's syndrome on the basis of a chest radiograph was subsequently, at the age of 23 years, found to have an adenoid cystic carcinoma obstructing the left main bronchus. This case emphasises the need to exclude a central lesion in cases of unilateral hyperlucent lung.     

A case of adenoid cystic carcinoma of the left main bronchus, which was performed carinal resection and reconstruction while the aortic arch is pulled down

A 55-year-old woman, who had treated as bronchial asthma for eight months, was admitted to our hospital. Chest CT scan showed a mass in the left main bronchus. Bronchoscopic examination revealed a tumor obstructing the left main bronchus and invading the left lower portion of the trachea. The pathologic diagnosis was adenoid cystic carcinoma. Primary resection of the left main bronchus and the carina with the objective and one-stoma-type carinal reconstruction were performed by the left thoracotomy. We pulled down the aortic arch to obtain an operative field, and carried out the operative procedure at the upper side of the aortic arch. As the resection margin contained residual tumor, the postoperative irradiation (50 Gy) was added.     

Compression of trachea and left main bronchus by arch aneurysm

We report on the case of a 70-year-old woman who presented dyspnea. Contrast-enhanced computed tomography of the chest revealed the compression of the lower part of the trachea and left main bronchus by an aneurysm of the ascending aorta and aortic arch. Although we performed a replacement of the ascending aorta and aortic arch, we were unable to relieve the stenosis of the trachea and bronchus. By the suspension of the posterior wall of the native aneurysm, we were able to successfully relieve the compression and alleviate the respiratory insufficiency.     

Carinal resection, left pneumonectomy, and right lung anastomosis for adenocystic basal cell carcinoma (cylindroma)

The surgical approach to, and resection of, a cylindroma of the left main bronchus involving the trachea and right main bronchus is described. The literature on bronchial adenoma and cylindroma is reviewed, both the pathogenesis and surgery being discussed. A plea for a more aggressive approach is made.     

Wedge carinal resection for closure of the main bronchus after pneumonectomy

Closure of the bronchial stump after pneumonectomy can be challenging. Some special situations such as tumor extension, technical pitfalls, or poor tissue quality of the bronchial stump may preclude safe closure of the airway with standard techniques. We describe here a technique of wedge carinal resection that provides the surgeon an alternative whenever the standard closure of the stump is inapplicable. This technique has been successfully used in a series of 4 patients.     

Slide plasty of trachea and right main bronchus in a newborn

Congenital stenosis of airways is a rare and possibly life-threatening congenital defect with difficult treatment and uncertain prognosis. In our report, we describe a rare case of a 1-month-old newborn with concomitant stenosis of trachea and main bronchus and its successful treatment using slide plasty.