Foreign body aspiration diagnosed by microscopy

We report a rare case of foreign body aspiration diagnosed by microscopic a nalysis of a sam pie of the foreign body. A 50-year-old man presented with a 5-month history of 40 pound weight loss and a nonresolving right lower lo be pneumonia. Medical history, radiographic studies, direct visualization o f the foreign body by flexible fiberoptic bronchoscopy, and gross examinati on of a sample of the foreign body retrieved by a forceps biopsy catheter r ailed to yield the diagnosis. Moderate bleeding associated with the broncho scopic "biopsy" procedure contributed to a preliminary misdiagnosis of endo bronchial tumor. Microscopic analysis of the "biopsy" specimen demonstrated vegetable matter. The patient underwent rigid bronchoscopy and a peanut wa s retrieved from the bronchus intermedius. He was maintained on antibiotics for an additional 8 weeks and had complete clinical and radiographic recov ery. The epidemiology, presentation, and management strategies of foreign b ody aspiration in the adult are briefly reviewed.