Research advances in Dieulafoy's disease of the bronchus (Review)

Abstract

Dieulafoy's disease is characterized by abnormal submucosal arteries and results in acute luminal hemorrhage. Dieulafoy's lesions can also be found in the submucosa of the bronchus. Due to its low incidence rate and non-specific clinical symptoms, Dieulafoy's disease is easy to overlook, but can lead to massive bleeding and high rates of mortality. Therefore, improvements in the understanding of the disease are necessary. The awareness of the disease and associated diagnostic and treatment techniques have continued to improve, and thus, an increasing number of cases of Dieulafoy's disease of the bronchus have been reported. In the present review, 74 cases of Dieulafoy's disease are summarized. New technologies such as endobronchial ultrasound, narrow-band imaging, angiography and argon plasma treatment have been found to be increasingly applied to diagnose and treat Dieulafoy's disease of the bronchus. Therefore, the primary focus of this systematic review is to highlight advances in the diagnosis and treatment of bronchial Dieulafoy's disease.

Keywords: Dieulafoy's disease; bronchi; diagnosis; outcome; treatment.

Figure 1

Small nodular protrusion from the mucosa of the left lingual segment of the bronchus. Protrusion of ~3 mm in diameter and height, coated with yellow-white exudate, and forming a ‘little while hat’ (black arrow).

Figure 2

Abnormal vessels are tortuous and dilated, with purple earthworm-like alterations (black arrow) in the submucosa of the posterior basal segmental bronchus of the right lower lobe.

Figure 3

Thickened and disordered lower right bronchial artery shown by bronchial angiography.

Figure 4

A 1.5-mm diameter small blood vessel in a submucosal lesion examined by endobronchial ultrasound in color Doppler mode.