case_images: PMC10616251_01
case_images: Chest CT of the patient. (A) Preoperative examination before bronchoscopy. CT scan revealed occlusion of the left main bronchus. (B) An irregular soft tissue mass was observed in the lower left lung.
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case_images: F1
case_images: Upon admission, a chest CT scan revealed occlusion of the left main bronchus, segmental atelectasis of the left lower lung, and cystic low-density shadows along the bronchial pathway (Figure 1).
case_images: (A) Bronchoscopy revealed a polypoid neoplasm that nearly completely obstructed the lumen of the left main bronchus. (B) After resection of the intratracheal mass, the distal part of the basal segment of the left lower lung remained obstructed. (C) The pathological report indicated an inflammatory myofibroblastic tumor. (D) Nuclear pleomorphism was also observed in the lavage fluid.
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case_images: F2
case_images: Fiber bronchoscopy was performed, and it revealed the presence of polypoid neoplasms in the left main bronchus, which almost completely obstructed the lumen (Figure 2A). Even after treatment, it could be seen that the distal left lower lobe basal segment remained obstructed (Figure 2B).
case_images: Key surgical steps: (A,B) After dissecting the pulmonary ligament, the left lower pulmonary vein was cut and sutured using a linear cutting device. (C,D) The proximal portion of the left lower bronchus was incised, and its contents were suctioned. (E,F) The proximal portion of the left upper bronchus was severed, and the left main bronchus was cut from its distal end. (G) The left lower lobe was excised using a linear cutting device. (H) Finally, the bronchial resection margin were trimmed, and the two ends were sutured continuously using absorbable sutures.
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case_images: F3
case_images: Additionally, thoracic lymph nodes were methodically cleared (Figure 3).
case_images: (A) Postoperative CT scan revealed a patent airway without any apparent surgical complications. (B) Histopathological examination of the postoperative specimen demonstrated increased thin-walled blood vessels and a few scattered large cells within an inflammatory cellular background.
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case_images: F4
case_images: The drainage tube was removed on the fifth day post-operation, and the patient was discharged one day later (Figure 4).