Conservative management of a broncho-oesophageal fistula in a patient with non-Hodgkin's lymphoma.

We describe the case of a 56-year-old male patient with a 2-year history of productive cough and weight loss. The diagnosis of a broncho-oesophageal fistula due to a low-grade Non-Hodgkin's lymphoma was made. The patient was referred for surgical closure of the fistula and resection of the left lower lobe because of intractable severe pneumonia. As an alternative treatment option, oesophageal or bronchial stent placement was considered. Because of the relatively favourable prognosis of this type of lymphoma, treatment with chemotherapy alone and a feeding gastrostomy were started. After eight cycles of cyclophosphamide and prednisone, the fistula healed spontaneously. Two years later, the patient continues to do well and is in remission. In patients with Non-Hodgkin's lymphoma and an oesophagorespiratory fistula, treatment should first be conservative; surgery or stent placement should be postponed.