Bronchial Stenosis After Iron Pill Aspiration

Iron pill aspiration: Cytologic and histologic findings of a potential life‐threatening airway injury. A Case report and literature review

“…The morphological findings of our case are similar to other cases with reported biopsies taken in the acute phase and characterized by the presence of extensively necrotic mucosa with numerous golden‐brown and coarsely fibrils, staining positive for iron stains (Perls) . Additional findings suggestive of an aspiration event are the presence of budding yeasts consistent with Candida , which supported the occurrence of an aspiration event, when the first hypothesis of a pill aspiration was considered.…”

“…Including our case, three other cases had cytologic specimens collected along with biopsy. Cytology specimens resulting from bronchial washings consistently revealed necro‐inflammatory exudates involving extra‐cellular golden‐brown fibrils . In two cases, reactive squamous cells were documented .…”

“…The mean age was of 68.5 years (range of 36–92 years). In only 50% of the cases the aspiration event was noticed by the patient or recalled after a detailed clinical history taken retrospectively . The most frequent symptoms in the acute phase, defined as the first two weeks after the aspiration event, where coughing (53%), four patients presented with brown sputum and eight with obvious hemoptysis .…”

“…The most common was atelectasis, followed by lung condensation and patchy opacifications. Suspicious images for foreign body were documented in three chest‐CT scan images, described as high density or nodular material in the bronchial lumen …”

“…Bronchoscopy examinations performed in the acute phase, consistently revealed a yellow‐brown discolored, necrotic mucosa, occasionally forming a polypoid mass, markedly friable with easy bleeding when touched . Necrosis, inflammation, and pigments were reported to last up to two months …”