Laser therapy for an obstructing primary tracheal lymphoma in a patient with AIDS (1)
Airway obstruction is a potential complication of tracheobronchial tumours. Patients often present with symptoms suggestive of asthma and the tumour is missed on initial evaluation. The failure of initial therapy to resolve the symptoms eventually leads to bronchoscopic examination, which reveals the tumour and leads to definitive therapy. Patients rarely present with respiratory failure or airway obstruction requiring stabilization before definitive therapy. We report the case of a patient with primary tracheal lymphoma and AIDS complicated by airway obstruction. buy asthma inhalers
A 37-year-old woman with AIDS presented to St Joseph’s Hospital in Hamilton, Ontario, for dyspnea, wheezing and worsening cough. Two weeks earlier, she had been admitted and treated for suspected Pneumocystis carinii pneumonia. After discharge, she continued to intermittently experience the same symptoms, but in a worsening and progressive fashion. Her physical examination was unremarkable except her heart rate was 116 beats/min, her respiratory rate was 29 breaths/min, and bilateral basilar crackles and wheezes were heard. She was admitted and administered supplemental O2, nebulized bronchodilators and systemic steroids. Her chest radiograph was initially interpreted as showing no gross abnormality; however, spirometry after bronchodilator therapy was consistent with a fixed obstructive defect (Figure 1).
Figure 1) Flow volume loop and bed side spirometry showing a fixed obstructive defect. Act Actual; Pred Predicted