We describe the case of a 54 year old woman seen with an esophageal mass diagnosed as a primary esophageal lymphoma. The main symptom was dysphagia of seven months duration. The treatment consisted in resection of the tumor, and reconstruction of the defect with a reversed pleural flap, followed by a chemotherapy regimen that consisted of five drugs, cyclophosphamid, prednisone, doxorubicin, rituximab and vincristine (R-CHOP). The patient developed an esophageal pleural fistula treated with pleural drainage and irrigation that closed in 45 days. Two and one half years later she is doing well and disease free.

É descrito o caso de uma paciente de 37 anos de idade atendida em virtude de dispnéia progressiva com duração de 18 meses. O diagnóstico inicial foi de asma brônquica. Teve 10 episódios de pneumonia envolvendo principalmente a língula nos últimos sete anos. Dezessete anos antes da admissão foi submetida a intubação orotraqueal por 15 dias, devido a coma por meningite meningocócica. A broncofibroscopia revelou alargamento da carina e estenose dos brônquios principais, confirmado pela broncoscopia virtual. A estenose era mais acentuada e curta à direita (1cm) e menos cerrada e mais longa à esquerda (2cm). Foi submetida a ressecção da carina e anastomose do brônquio principal direito à traquéia e do brônquio principal esquerdo ao brônquio intermediário. Quinze meses depois do procedimento a paciente apresenta boa evolução clínica, radiológica e funcional.

We report on a 37-year-old female patient who was first seen on account of a progressive dyspnea of 18 month's duration. Admission diagnosis was bronchial asthma. Over the past seven years, the patient has had seven pneumonia episodes involving mainly the lingular segment. Seventeen years prior to admission (1982) she was orally intubated for 15 days due to meningococcus meningitis and coma. Fiberoptic bronchoscopy revealed marked widening of the carina and stenosis of the main bronchi, confirmed by virtual bronchoscopy. The stenosis was shorter and more severe to the right side (1 cm) and longer and less severe on the left side (2 cm). The patient was submitted to carina resection and anastomosis of the right mainstem bronchus to the trachea and the left main bronchus to the bronchus intermedius. Fifteen months after surgery the patient shows good clinical, radiological and functional evolution.