Airway foreign body with clinical features mimicking bronchial asthma

A 56-year-old Japanese male with persistent cough, strider and diffuse whee zing for 6 months had obstructive pulmonary dysfunction and airway hyperres ponsiveness (AHR) to inhaled methacholine, Because of a poor response to gl ucocorticoid therapy and neutrophilia in the peripheral blood and sputum, c hest computed tomography was performed and a plate-like tumor in the truncu s intermedius was identified. Fiberoptic bronchoscopy demonstrated a plate- like green-colored tumor firmly impacted into the truncus intermedius and d iffuse inflammatory changes spreading to both main bronchi, A piece of 'kom bu' (Japanese kelp) was successfully removed by fiberoptic bronchoscopy und er general anesthesia. Pulmonary function and methacholine inhalation tests became normal after the removal of the foreign body. in this case, it is s uggested that asthma-like symptoms were due to localized airflow limitation in the right bronchus as well as to AHR associated with diffuse airway neu trophilic inflammation. Copyright (C) 2001 S. Karger AG, Basel.