BMJ Case Reports 2013; doi:10.1136/bcr-2012-007766
  • Rare disease

An unusual bronchial obstruction in a fit young man

  1. Ramesh J Kurukulaaratchy
  1. Department of Respiratory Medicine, Southampton General Hospital, Tremona Road, Southampton, Hampshire, SO16 6YD, UK
  1. Correspondence to Dr Ramesh J Kurukulaaratchy, Ramesh{at}


We describe the case of a previously well young man who presented acutely to hospital with a history of progressive chest symptoms and systemic upset. At admission, clinical evidence of left upper lobe collapse on respiratory examination and chest x-ray gave rise to significant clinical concern. Initial assessment by CT suggested a possible aspirated foreign body in the left upper lobe bronchus with distal left upper lobe collapse. Subsequent rigid bronchoscopy identified a solid abnormality totally occluding the left upper lobe bronchus, which did not appear to be a foreign body. The patient became progressively more unwell with clinical signs of chest sepsis and failed to settle with medical therapy. A decision was made to undertake a lobectomy to remove the collapsed lobe and obstructing endobronchial lesion. Histology confirmed that the cause of bronchial obstruction was a mesenchymoma (pulmonary hamartoma).

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