International Journal of Clinical & Medical Images

Clinical-Medical Image

Coin aspiration has been rarely reported in adults, although common in children. We report an interesting case of incidentally found coin aspiration. An elderly male was referred to the pulmonary clinic for evaluation of a foreign body found on chest radiograph (Figures 1 and 2). The radiograph was performed for annual follow up of stage II-B left upper lobe squamous cell carcinoma, diagnosed in November 2008 and treated with left upper lobe lobectomy and chemotherapy. He reported usual exertional dyspnea and occasional cough but denied any other symptoms as well as history of aspiration event. Physical examination was only remarkable for obesity (BMI 33). Pertinent laboratory tests revealed white cell count 10.8 × 109 /L, hemoglobin 12.4 g/ dL, and creatinine 1.6 mg/dL. Chest radiograph was concerning for a metallic coin shaped object overlying the right bronchus intermedius. Flexible fiberoptic bronchoscopy revealed a dime embedded in mucoid secretions in the right bronchus intermedius and did not appear adherent to the bronchial wall. All secretions were cleared and the dime was removed with forceps without any issue (Figure 3). Patient was discharged home without complications and referred for speech evaluation.