CASE 643: MUCUS SECRETION versus ENDOLUMINAL TRACHEA TUMOR, LÊ HỮU LINH MD, MEDIC MEDICAL HCMC, VIETNAM

A 63 year-old male patient goes to the doctor as bloody sputum coughing for some days with feeling of suffocation. There was no pathological sign or symptom of other organs. Inflammed blood tests, and coagulation tests were in normal range. 

Chest CT scan in a local hospital showed a small nodule at the posterior wall of the trachea which was suspected a tracheobronchitis or a papilloma of the trachea. 

His wife and his familial doctor also want having a bronchoscopy for the patient at MEDIC.

3 days later, patient no longer spitted bloody sputum, and completely seems to be healthy. The pulmonologist decided to repeat chest CT and virtual bronchoscopy for the patient. Chest CT at MEDIC showed tracheal lesion disappeared.

DISCUSSION:

Characteristics to detect a mucus secretion in trachea:

•       Small size.

•       At posterior wall of trachea (supine position during CT scan procedure).

•       Small air shadow within the nodule suggesting mucus secretion.

•       It will be transformed or disappeared after coughing.

 

CONCLUSION:

Mucus secretion in trachea can be mistaken with endoluminal trachea tumor.

Their characteristics on chest CT should be put under caution. And a repeated CT scan made after coughing may help detecting a mucus secretion. Thanks of that we could avoid unnecessary invasive procedure for patient. 

Reference case: 

A case with chest CT showed multiple nodular lesions that were both upper lobes, indicated a pulmonary tuberculosis. And it existed a small nodule at posterior wall of trachea. After coughing, repeated CT scan showed the nodule of trachea disappeared.