PMC4840405_01
Computed tomography scan of the chest showing a 3.2 x 3.3 cm hilar mass with endo-bronchial extension, narrowing the right main bronchus (A). Computed tomography scan of the chest showing a thick walled cavity in the right upper lobe with tracheo-parenchymal fistula just above the right upper lobe bronchus (B). Bronchoscopy revealed a tracheoparenchymal fistula connecting the right main bronchus to a large cavity in the right upper lobe, destroying majority of the right main bronchus and causing significant attenuation of the bronchus intermedius (C).
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Initial chest tomography (CT) of chest revealed a hilar mass measuring 3.2 x 3.3 cm with some endo-bronchial component, narrowing the right main bronchus (Fig. 1A). CT chest with contrast (Fig. 1B) revealed the development of thick walled cavity in the right upper lobe (RUL) entered into the trachea just above the right upper lobe bronchus, in the largest dimension the was 7.5 x 4.5 cm in size. However, due to continued fevers a bronchoscopy was done, this revealed the large cavity, The bronchus intermedius that was almost completely walled off and a stent to open up the lower lobe was not placed due to the high risk of converting the cavity into an abscess (Fig. 1C).