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Antiasthmatic versus surgical treatment-how important is the precise analysis of spirometry?

J Asthma. 2011 May;48(4):341-4. Swiebocka E, Siergiejko P, Grygorczuk A, Siergiejko Z. Department of Pediatrics, Gastroenterology and Allergology, University Children Hospital, Bialystok, Poland.

OBJECTIVE: Carcinoids are low-grade, slow growing malignant tumors in the bronchi usually producing symptoms secondary to bronchial obstruction. We describe a case of 25-year-old woman who was initially diagnosed with asthma.

METHOD: Case report.

RESULTS: Because of exacerbation and unresponsiveness to proper asthma treatment she was referred to spirometry, which showed low values of forced expiratory volume in 1 second. The shape of inspiratory limb of flow volume curve suggested an obstruction in the main bronchus or in the trachea. Further bronchoscopy revealed a tumor of the right main bronchus with characteristic histological features for carcinoid.

CONCLUSIONS: Both the inspiratory curve and the expiratory part of the flow-volume loop should be evaluated in patients being evaluated for asthma. If there are changes in the shape of the inspiratory limb suggesting an obstruction, CT and/or bronchoscopy should be considered.

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