Safe Bronchoscopic Treatment Strategy for Subglottic Severe Airway Stenosis: A Case Report of Tracheal MALT Lymphoma

An 86-year-old woman with dyspnea was referred to the Interventional Pulmonology Department due to airway stenosis just below the vocal cords. Bronchoscopic intervention was performed. During the procedure, the right femoral artery and vein were accessed, with a cardiologist and otolaryngologist on standby for emergency tracheotomy. Severe (> 90%) stenosis posed a high risk of respiratory depression and suffocation; therefore, muscle relaxants were not used, and only intravenous anaesthesia was administered. Initially, a laryngeal mask was used, and 2% lidocaine was applied to the airway. A rigid bronchoscope was positioned before the stenosis for airway control. The stenosis, located in the membranous portion, was debulked using a cryoprobe starting from the central area, followed by core-out with a rigid bronchoscope and further dilation with the cryoprobe. Haemostasis was achieved with argon plasma coagulation. The procedure was successful, and symptoms improved. The pathological examination of the cryobiopsy confirmed a diagnosis of mucosa-associated lymphoid tissue lymphoma.