Bronchial fibroepithelial polyp: a clinico-radiologic, bronchoscopic, histopathological and in-situ hybridisation study of 15 cases of a poorly recognised lesion

Case report: Bronchoscopic intervention for rare benign airway tumors: a report of 4 cases and literature review

Due to their unique location, airway tumors have a significant impact on patient quality of life and survival. Current research has focused extensively on malignant airway tumors; however, benign airway tumors, especially rare ones, are less understood due to their low incidence. These tumors are often misdiagnosed and mistreated due to diagnostic challenges. Therefore, there is still a lack of consensus on the treatment of some rare benign airway tumors. Our center summarizes the diagnosis and treatment of four rare cases of benign airway stenosis in recent years, highlighting the bronchoscopic manifestations and therapeutic approaches to improve the understanding of these diseases.

Misdiagnosed Asthma Turned Out to Be Bronchial Fibroepithelial Polyp: Case Report and Review of Literature

Bronchial fibroepithelial polyps are exceedingly rare with few cases have been reported. They can manifest with a wide array of symptoms; ranging from being totally asymptomatic, cough, refractory dyspnea, and hemoptysis. In our case, our patient's condition was diagnosed and was managed as asthma. It is one of the rare benign conditions to be encountered, shares similar morphology with other tumors such as angiomyofibroblastoma, aggressive angiomyxoma, and cellular angiofibroma. These lesions have a slow growth pattern which may end up with obstruction. According to the tumor size and symptoms caused by it, treatment varies from observation to complete resection. This case describes an incidental finding of fibroepithelial polyp in the main bronchus for a patient with long-term refractory cough for 5 years, was misdiagnosed to have asthma. Diagnosis typically involves imaging and bronchoscopy, followed by appropriate therapeutic measures and careful monitoring to assess the prognosis.

Giant hypopharyngeal fibroepithelial polyp: A case report and literature review

Hypopharyngeal fibroepithelial polyp is a rare entity. It could extend along the esophagus, leading to dysphagia. In rare cases, this polyp could present as airway compromise due to occlusion of the inlet of the larynx. The treatment of choice is surgical resection. Accurate defining of the origin of such polyp is mandatory in order to achieve complete resection and avoid recurrence. Although hypopharyngeal FEP is rare, physicians must keep this in mind when a patient presents dysphagia or airway compromise. In the current case, we present a rare case of giant hypopharyngeal FEP originating from the right pyriform sinus detected in a Caucasian female. The patient threw up the polyp after severe vomiting. This case should be the fourth and largest case of hypopharyngeal FEP reported in the literature.

Bronchial Fibroepithelial Polyp With Severe Hemoptysis as First Manifestation: A Case Report

Fibroepithelial polyps are uncommon benign tumors that mostly occur in skin, oral cavity and genitourinary tract. These lesions have common morphological features with other mesenchymal tumors such as angiomyofibroblastoma, aggressive angiomyxoma, and cellular angiofibroma and present with numerous histological appearances. Benign endobronchial tumors are rare. These neoplasms have a slow growth and usually are related to bronchial obstruction. Only a few cases of bronchial fibroepithelial polyps have been reported. Bronchial fibroepithelial polyps might present with airway stenosis resulting in atelectasis and bronchiectasis and the most frequent manifestations are recurrent infection, refractory asthma, dyspnea and hemoptysis. Chronic inflammation is associated with the pathogenesis of fibroepithelial polyps. Treatment varies according to mainly to the size and symptoms. Small lesions presenting with few symptoms can be treated with corticosteroids and antibiotics while invasive techniques including bronchoscopic resection of the polyp or lobectomy are used for larger lesions. We report a case of a bronchial fibroepithelial polyp with severe hemoptysis as the first manifestation. Physicians should always suspect these lesions in the differential diagnosis of hemoptysis and with initial right diagnosis surgical procedures can be avoided.

Therapeutic endobronchial resection of a benign tumor in a patient with cystic fibrosis

This report highlights the usefulness of bronchoscopy in case of recurrent pneumonia with the same localization even in CF patients where the presence of bronchiectasis as promoting factor of infections could delay the diagnosis.

Characterisation of tumour microvessel density during progression of high-grade serous ovarian cancer: clinico-pathological impact (an OCTIPS Consortium study)

BACKGROUND

High-grade serous ovarian cancer (HGSOC) intratumoural vasculature evolution remains unknown. The study investigated changes in tumour microvessel density (MVD) in a large cohort of paired primary and recurrent HGSOC tissue samples and its impact on patients' clinico-pathological outcome.

METHODS

A total of 222 primary (pOC) and recurrent (rOC) intra-patient paired HGSOC were assessed for immunohistochemical expression of angiogenesis-associated biomarkers (CD31, to evaluate MVD, and VEGF-A). Expression profiles were compared between pOCs and rOCs and correlated with patients' data.

RESULTS

High intratumoural MVD and VEGF-A expression were observed in 75.7% (84/111) and 20.7% (23/111) pOCs, respectively. MVD^high and VEGF⁽⁺⁾ samples were detected in 51.4% (57/111) and 20.7% (23/111) rOCs, respectively. MVD^high/VEGF⁽⁺⁾ co-expression was found in 19.8% (22/111) and 8.1% (9/111) of pOCs and rOCs, respectively (p = 0.02). Pairwise analysis showed no significant change in MVD (p = 0.935) and VEGF-A (p = 0.121) levels from pOCs to rOCs. MVD^high pOCs were associated with higher CD3⁽⁺⁾ (p = 0.029) and CD8⁽⁺⁾ (p = 0.013) intratumoural effector TILs, while VEGF⁽⁺⁾ samples were most frequently encountered among BRCA-mutated tumours (p = 0.019). Multivariate analysis showed VEGF and MVD were not independent prognostic factors for OS.

CONCLUSIONS

HGSOC intratumoural vasculature did not undergo significant changes during disease progression. High concentration of CD31⁽⁺⁾ vessels seems to promote recruitment of effector TILs. The study also provides preliminary evidence of the correlation between VEGF-positivity and BRCA status.

Hierarchizing caries risk factors among first-year university students in Nice (France): a cross-sectional study

BACKGROUND

The purpose of this study was to rank the risk factors for dental caries among first-year university students in Nice (France).

METHODS

All first-year students are required to undergo a compulsory preventive medical examination. Among these students, volunteers were offered a dental visit. Information was collected through an interview followed by an oral examination. We assessed the volunteers' oral hygiene habits (daily toothbrushing frequency, type of toothbrush used, frequency of toothbrush replacement, place of toothpaste purchase, and flossing), daily health-related behaviors (number of main daily meals, daily sugary intakes, smoking, alcohol consumption, consumption of cannabis or other drugs), oral-health-related behaviors (self-reported oral health, dental visits during the past year, reason for the last dental consultation, and failure to seek dental care due to financial reasons), and oral health issues (dental crowding, oral hygiene, presence of caries, presence of pit and fissure sealant remnants). The dependent variable was the presence of at least one untreated carious lesion. The data were subjected to univariate analyses to select explanatory variables, and subsequently, a logistic regression was performed.

RESULTS

Six hundred twenty-nine students aged 18.8±1.6 years were enrolled in this study. The sex ratio was 0.72, with a strong predominance of the female gender. Only 59.3% of the students had never experienced dental caries, while 22.4% had already undergone restorative procedures and did not have any carious lesion at the time of the examination, and 11.6% presented with carious lesions and had never been treated by a dentist. Lastly, 6.7% had carious lesions despite evidence of prior restorative procedures. The multivariate analysis revealed the following pejorative risk factors: failure to seek dental care due to financial reasons (OR:3.06, 95% CI: 1.40-6.70), poor oral hygiene revealed during the oral examination (OR:2.59, 95% CI: 1.60-4.20), and poor self-reported oral health (OR:2.43, 95% CI: 1.24-4.77). Conversely, the analysis revealed the following protective factors: preventive visits to the dentist (OR:0.63, 95% CI: 0.41-0.99), the use of an electric toothbrush (OR:0.36, 95% CI: 0.17-0.77), and sealant remnants (OR:0.22, 95% CI: 0.05-0.97).

CONCLUSIONS

The highest-ranking caries risk factor for the study population was the financial barrier.

Airway fibroepithelial polyposis

Fibroepithelial polyps are benign lesions, frequently found in the skin and genitourinary tract. Airway involvement is rare, and few case reports have been published. Our patient was a 79 y.o. male smoker, who was referred to us with a 3-month history of dry cough. At physical examination, the patient looked well, but a chest CT showed a 6-mm polyp lesion in his trachea. A flexible bronchoscopy confirmed this lesion, and forceps biopsies were performed. Argon plasma coagulation was used to completely resect and treat the lesion. Pathological analysis revealed a fibroepithelial polyp (FP). The aim of this manuscript is to report a case of FP with bronchoscopic management and to review the current literature about this condition.

A bronchial fibroepithelial polyp with abnormal findings on auto-fluorescence imaging

Bronchial fibroepithelial polyps represent a rare type of tumour that displays endobronchial growth. The findings of these lesions on auto‐fluorescence imaging (AFI) bronchoscopy have not been reported, despite the usefulness of AFI in detecting early lung cancer. We report the case of a patient with a bronchial fibroepithelial polyp that displayed positivity (magenta colour) on AFI. The patient was a 65‐year‐old man, in whom an endobronchial polypoid lesion of 10 mm diameter had been detected in the right basal bronchus by chest computed tomography (CT). On bronchoscopic examination, we found a whitish, smooth polypoid lesion. The lesion appeared magenta on AFI. On CT, however, the lesion had been almost stable for 4 years and 4 months. Bronchial fibroepithelial polyps may show AFI positivity, even when the lesion displays benign behaviour. The diagnosis of the lesion should not be confused by AFI positivity, and unnecessary surgical intervention should be avoided.