The patient was a woman. At a dental extraction 4½ years previously a tooth was inhaled. After this she suffered recurrent haemoptyses, and examination and X-ray suggested involvement of the lower lobe of the left lung. Repeated attempts to remove the tooth through a bronchoscope failed. Lower lobectomy was performed.
The specimen consists of a segment of the basal lobe of the left lung. A tooth is seen to be impacted at the bifurcation of a bronchus. The wall of the involved bronchus is irregularly thickened proximal and distal to the tooth. The lumen is irregularly dilated. The bronchial epithelium proximal to the obstruction is hyperplastic with small polypoid elevations. The lung tissue distal to the obstruction is collapsed and shows a small area of lipoid pneumonia in its proximal portion.