Misinterpreted expansive process of the middle lobe of the lung caused by unnoticed aspiration of a tooth

: In a patient of 78 years of age a diagnosis of a suspected expansive process of the middle lobe was made on the basis of the clinical findings and a plain radiography of the thorax. Fibre bronchoscopy revealed a subtotal stenosis of the middle lobe bronchus on the right side. The tissue sample revealed a chronically inflamed granulated tissue. Subsequent tomography of the hilus region in two planes showed a foreign body situated in the bronchus intermedius and extending into the middle lobe bronchus. Bronchoscopy was then repeated and an incisor tooth with two mental clamps was removed. A remarkable fact in this case was that the patient was unable to remember the aspiration incident, and it was also remarkable that the shape of the shadow that showed up in the middle lobe segment justified the suspicion of a tumour, although generally atelectasis or pneumonia show up on the x-ray film as sequels of an aspiration if an aspiration has taken place.