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Severe Bronchorrhea in a Patient with Bronchioloalveolar CarcinomaBronchorrhea in Bronchioloalveolar Carcinoma

Nooreen Popat, MD; Natya Raghavan, MDCM; R. Andrew McIvor, MD, FCCP
Author and Funding Information

From the Department of Medicine (Drs Popat and McIvor), McMaster University, Hamilton, ON, Canada; and the Department of Internal Medicine (Dr Raghavan), Kingston General Hospital, Kingston, ON, Canada.

Correspondence to: Nooreen Popat, MD, Department of Medicine, McMaster University, T2127, FIRH, 50 Charlton Ave E, Hamilton, ON, L8N 4A6, Canada; e-mail: nooreen.popat@medportal.ca


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(2):513-514. doi:10.1378/chest.11-0956
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Mucinous bronchioloalveolar carcinoma (BAC) can be associated with significant bronchorrhea. A 46-year-old man presented with BAC with 2,000 mL of sputum production on a daily basis, which prevented him from being extubated. As this condition is rare, there are only case reports outlining the therapy for the associated bronchorrhea. We used azithromycin, scopolamine, and inhaled fluticasone with moderate success. The initiation of an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, gefitinib, resulted in dramatic improvement in the volume of pulmonary secretions produced. The patient’s EGFR mutation status was subsequently found to be negative, which supports the hypothesis that the mechanism of reduction of bronchorrhea is independent of the antiproliferative effect of the drug.

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