Journal of Asthma, Allergy and Clinical Immunology  1999;19(1):103-109

Two cases of upper airway obstruction masquerading as asthma: One tracheal adenoid cystic carcinoma, the other foreign body aspiration.

Hak Geun KIM ; Han Kyun LEE ; Bum Chan KWEON ; Choong Ki LEE ; Gun Woo KIM ; Sang Hoon HYUN ; Jong Myung LEE ; Nung Soo KIM

Keywords

bronchial asthma; upper airway obstruction; adenoid cystic carcinoma; foreign body aspiration

Country

Republic of Korea

Language

Korean

Abstract

Reversible airway obstruction and wheezing are typical features of bronchial asthma, but these features may also be observed in other conditions. However, the inclusion of these conditions in the differential diagnosis of asthma-like symptoms in adults is often neglected, resulting in a correct diagnosis being made after months of unsuccessful treatment for asthma. We report two cases of an upper airway obstruction masquerading as asthma. In case one, adenoid cystic carcinoma was identified in the trachea of a patient showing asthma-like symptoms, positive response to allergic skin test and methacholine inhalation challenge. In the other case, aspirated foreign body was misdiagnosed and treated as asthma for more than one year. A high degree of suspicion and a thorough medical evaluation censisting of history, physical examination and pulmonary function test including shapes of spirogram are essential to the differential diagnosis of asthma-like symptoms