Temporary use of silicone stents for severe airway stenosis in untreated malignant lymphoma

Background: Airway stenting has become a popular method for palliation of airway stenosis; however, little has been reported about their use for patients with malignant lymphoma that occasionally causes a lifethreatening condition. The aim of the study was to evaluate the efficacy and safety of airway stenting in chemoradiotherapy naive patients with severe airway stenosis due to malignant lymphoma. Methods: Patients who underwent airway stent placement from April 2007 to July 2011 in a single center were retrospectively reviewed. All stenting procedures were performed using rigid and flexible bronchoscopes under general anesthesia. Results: We performed 174 airway stenting procedures (silicone stents in 154 procedures and metallic in 20 procedures) for 150 patients during the study period. Of the patients, 7 had untreated malignant lymphomas (4 diffuse large B-cell lymphomas, 2 lymphoblastic lymphomas, 1 mucosa-associated lymphoid tissue lymphoma). All patients underwent stenting using the silicone Y-stent (6 on the main carina and 1 on the primary right carina). Dyspnea was relieved immediately in 6 of 7 patients including the mechanically ventilated patient. Stents could be removed in all patients (median 90 d after stenting; range, 32 to 245 d) because of the tumor response to tumor-specific therapy. One granuloma formation and 1 mucus retention triggered the decision to remove the stents. Conclusions: Airway stenting using silicone stents is safe and effective in palliation of airway stenosis in patients with untreated malignant lymphoma, and permits postprocedural tumor-specific therapy. The response to tumor-specific therapy can be expected, and so removable stents should be selected.