CRA69 FOREIGN BODY ASPIRATION MIMICKING AN ENDOBRONCHIAL TUMOUR: A CASE REPORT UNVEILING SILENT STROKE

¹Nurul Aimi Abd Ghani, ¹Irfhan Ali Hyder Ali, ²Lee Fong Wan

¹Respiratory Department, Hospital Pulau Pinang, ²Pathology Department Hospital Pulau Pinang, Penang, Malaysia

INTRODUCTION
Foreign body aspiration is uncommon in adults and is usually linked to older age, substance abuse, medications, and disorders affecting the central nervous system.

CASE PRESENTATION
We present a patient with severe aortic stenosis who had a one-month history of cough and right upper lobe atelectasis on chest radiograph. CT imaging revealed soft tissue obstructing the right upper lobe, raising concerns for malignancy. Bronchoscopy identified a nodular mass, with biopsy confirming vegetable matter. Following the procedure, the patient developed a fever and was treated with intravenous antibiotics. A referral for rigid bronchoscopy was made, but follow-up radiographs showed resolution of the lung collapse, and repeat bronchoscopy found no endoluminal mass before the procedure. Additionally, the patient had a history of choking episodes three years prior, and CT of the brain indicated an old infarct, leading to antiplatelet therapy for stroke management.

DISCUSSION
Foreign body aspiration in adults is uncommon and often linked to trauma or neurological issues. Diagnosis involves clinical history, imaging, and bronchoscopy. This case highlighted challenges in diagnosis due to foreign bodies' radiolucent nature, which can mimic other endobronchial tumours. While rare, spontaneous expulsion of foreign bodies can occur.

CONCLUSION
Foreign body aspiration is rare in adults, especially in the absence of clear risk factors such as trauma or neurological disorders. Identifying underlying factors, such as stroke in this case, is crucial for accurate diagnosis. Management of foreign body aspiration involves bronchoscopy and addressing underlying factors, such as stroke, as demonstrated in this case.