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Martinez Trevino EF, Sohail M, Mijares-Rojas IA, Qaddorah S, Levenson A. Endobronchial Obstruction: A Case of Well-Differentiated Liposarcoma. Cureus 2024; 16:e57731. [PMID: 38711696 PMCID: PMC11073832 DOI: 10.7759/cureus.57731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2024] [Indexed: 05/08/2024] Open
Abstract
Atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) is a rare subtype of endobronchial tumor that has been rarely reported in medical literature. Due to its low incidence, distinguishing it from endobronchial lipoma poses a significant diagnostic challenge, necessitating histopathologic and cytogenetic analysis. As of today, the treatment and surveillance protocols for these neoplasms remain poorly defined, often resulting in their misclassification and treatment as endobronchial lipomas. We present a case involving a 72-year-old male who presented with worsening dyspnea and cough. Diagnostic imaging revealed an endobronchial lesion obstructing the left main bronchus. The patient underwent a flexible bronchoscopy that identified a polypoid mass causing significant obstruction, which was subsequently resected via cryoablation. Histopathology confirmed ALT/WDL, supported by genetic analysis revealing chromosomal alterations. Following the intervention, symptoms resolved, with no recurrence on follow-up imaging. Differentiating ALT/WDL from endobronchial lipomas is necessary not only because it influences treatment decisions but also because it can significantly affect the prognosis of patients diagnosed with ALT/WDL. In this case, we emphasize the importance of considering ALT/WDL in the differential diagnosis of endobronchial tumors and highlight the use of flexible bronchoscopy as a viable substitute for rigid bronchoscopy, serving not only as a diagnostic tool but also as a therapeutic method.
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Affiliation(s)
| | - Momena Sohail
- Pulmonary and Critical Care Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | | | - Seba Qaddorah
- Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | - Anne Levenson
- Pulmonary and Critical Care Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
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2
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Chen J, Xin T, Pan L, Li Y, Qian W, Wei J, Yan Y, Wang Y, Jin F, Jiang H. Endobronchial Lipoma: A Rare Cause of Bronchial Stenosis or Obstruction. Can Respir J 2023; 2023:2799436. [PMID: 38170103 PMCID: PMC10761223 DOI: 10.1155/2023/2799436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/28/2023] [Accepted: 11/13/2023] [Indexed: 01/05/2024] Open
Abstract
Endobronchial lipoma (EL) is a rare benign tumor characterized by tracheobronchial smooth-surfaced mass, often resulting in bronchial obstruction without standard guidelines for management. This study seeks to clarify the clinical features and interventions of EL, aiming to improve its diagnosis and outcomes. A retrospective review was conducted on 28516 outpatients treated between January 2015 and December 2019 at the Department of Respiratory and Critical Care Medicine of the Second Affiliated Hospital of Air Force Medical University to collect patients diagnosed with EL. Their clinical, bronchoscopic, chest imaging, and histopathological features along with management were analyzed. Among the patients reviewed, nine were histopathologically diagnosed with EL, comprising seven males and two females. All EL patients exhibited noticeable symptoms, including cough (in eight patients), dyspnea (in six patients), fever (in three patients), expectoration (in two patients), chest pain (in two patients), hemoptysis (in one patient), and fatigue (in one patient). Chest CT abnormalities included endobronchial mass (in four patients), inflammatory exudation (in three patients), atelectasis (in three patients), and infiltration or consolidation (in two patients). In three patients, imaging showed fat density, directly leading to the diagnosis of EL. The EL lesions were distributed with six in the right lung and three in the left lung, all located within the first three subdivisions of the tracheobronchial tree. Treatment approaches varied, with one patient undergoing combined bronchoscopic resection and surgery. The remaining patients received bronchoscopic intervention such as electrosurgical snare resection, argon plasma coagulation (APC), cryotherapy, and holmium laser. Histopathological analysis confirmed the EL diagnosis. Finally, the mass removal restored bronchus patency. Taken together, EL symptoms lack specificity, necessitating reliance on histopathology for EL accurate diagnosis. Bronchoscopic interventions emerge as the preferred option for EL management, surpassing surgical approaches.
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Affiliation(s)
- Jian Chen
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
| | - Tao Xin
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
| | - Lei Pan
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
| | - Yan Li
- Department of Respiratory and Critical Care Medicine, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi, China
| | - Weisheng Qian
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
| | - Jin Wei
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
| | - Yan Yan
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
| | - Yan Wang
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
| | - Faguang Jin
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
| | - Hua Jiang
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
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3
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Nodar SR, Yllán VG, Ferrer NR, Solis O, Boccara HD. Endobronchial sialolipoma. Case report. Diagn Pathol 2021; 16:15. [PMID: 33612094 PMCID: PMC7897375 DOI: 10.1186/s13000-021-01074-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 02/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background A 52-year-old woman presented with shortness of breath and cough. An endobronchial sialolipoma was found at the left entrance of the main bronchus. Sialolipoma is an exceedingly rare type of lipoma reported of the minor salivary glands, especially within the bronchus. Case presentation A 52-year-old woman presented with shortness of breath and cough with 6 months´ evolution. Endobronchial endoscopy revealed a tumour at the left entrance of the main bronchus. The entire removal of the tumour was removed using a cryoprobe device. Pathological examination showed a tumour consistent with the diagnosis of sialolipoma due to the presence of mature adipose cells blended with acinar, ductal, basal, and myoepithelial cells. The patient had a favourable outcome. Conclusion The infrequent tracheobronchial presentation of this tumour can be challenging for correct diagnosis.
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Affiliation(s)
| | | | | | - Onay Solis
- FORESC (Foundation for Sciences and Research), Florida, USA
| | - Hugo D Boccara
- FORESC (Foundation for Sciences and Research), Florida, USA
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4
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[The GELF is over, long live the GETIF!!]. Rev Mal Respir 2021; 38:131-133. [PMID: 33581984 DOI: 10.1016/j.rmr.2021.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 11/22/2022]
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Endobronchial treatment of benign endobronchial neoplasms: Our 10 years of experience. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2021; 29:61-69. [PMID: 33768982 PMCID: PMC7970073 DOI: 10.5606/tgkdc.dergisi.2021.19488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 04/06/2020] [Indexed: 11/22/2022]
Abstract
Background
The aim of the study was to assess the safety, efficacy, complications, and long-term outcomes of endobronchial treatment for benign endobronchial tumors.
Methods
A total of 53 patients (39 males, 14 females; mean age: 53.7 years; range, 12 to 83 years) with the diagnosis of benign endobronchial neoplasms in our center between November 2010 and September 2019 were retrospectively analyzed. Data including demographic and clinical characteristics of the patients and treatment outcomes were examined.
Results
Tumors regressed in all patients with argon plasma coagulation, diode laser and electrocautery, which was combined with cryotherapy in some cases. Complications were observed in five (9%) patients. Major complications were atrial fibrillation in two patients and respiratory failure requiring mechanical ventilation in one patient. Minor complications were minimal bleeding in two patients. The response was very good in 39 (74%) patients and good in 12 (23%) patients. There was no significant difference in the residual tissue formation requiring cryotherapy among the endobronchial treatment modalities (p>0.05). The five-year survival rate was 94%. No endobronchial treatment-related mortality was observed in any of the patients.
Conclusion
Endobronchial treatment modalities including diode laser, electrocautery, and argon plasma coagulation combined with or without cryotherapy are effective and safe in the treatment of benign endobronchial tumors.
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Jadhav S, Sanagar S, Shaha J, Kutty J, Jadhav M. A Bronchial Lipoma: Occurrence at an Unusual Site and Its Successful Bronchoscopic Resection with an Electrosurgical Snare. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2020; 53:400-402. [PMID: 33115970 PMCID: PMC7721525 DOI: 10.5090/kjtcs.20.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/28/2020] [Accepted: 04/22/2020] [Indexed: 11/25/2022]
Abstract
Primary tracheobronchial lipoma is an extremely rare entity, the diagnosis of which is often missed initially. Cases are generally diagnosed late after initial treatment for asthma and bronchitis. We report a case of a 42-year-old man with a left main bronchus lipoma that caused near-total obstruction. The lipoma was treated by bronchoscopic resection with an electrosurgical snare and cryoablation.
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Affiliation(s)
- Sanjeev Jadhav
- Department of Cardiovascular and Thoracic Surgery, Apollo Hospitals, Navi Mumbai, India
| | - Sachin Sanagar
- Department of Cardiovascular and Thoracic Surgery, Apollo Hospitals, Navi Mumbai, India
| | - Jeenam Shaha
- Department of Pulmonary Medicine, Apollo Hospitals, Navi Mumbai, India
| | - Jayalakshmi Kutty
- Department of Pulmonary Medicine, Apollo Hospitals, Navi Mumbai, India
| | - Mona Jadhav
- Department of Anesthesia, Symbiosis Institute of Health Sciences, Pune, India
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7
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Zhao S, Shui Y, Dai Z. Multiple endo bronchial lipoma: a rare case report. BMC Pulm Med 2020; 20:251. [PMID: 32962678 PMCID: PMC7510283 DOI: 10.1186/s12890-020-01287-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 09/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background Endobronchial lipoma is an extremely rare benign tumor, which is generally located in the first three subdivisions of the tracheobronchial tree. According to the existing literature, all endobronchial lipomas are single (one per patient). Here, we report a rare case in which the patient presented with two endobronchial lipomas in the same patient, and underwent a bronchoscopic tumor resection in the left main bronchus and the left lower bronchus. Both tumors were pathologically confirmed as endobronchial lipoma. Case presentation A 52-year-old Chinese man presented at the clinic reporting a mild cough with yellow color sputum and exertional dyspnea for 2 weeks. He was a heavy smoker (45 pack-years). Chest auscultation demonstrated faint wheezing in left lower lobe. Computed tomography (CT) revealed two low-density endobronchial masses located in the middle segment of the left main bronchus and the posterior basilar segmental bronchus of the left lower lobe. The neoplasms measured a CT-attenuation value of -70HU, −98HU in density with air trapping and atelectasis in the segmental bronchus of the left lower lobe. The patient underwent interventional bronchoscopic management to remove the neoplasms by using an electrosurgical snare, cryotherapy, and electrocautery. The locations of the neoplasms were confirmed at the left main bronchus and the superior segment of the left lower lobe during bronchoscopic intervention. Histopathological examination confirmed that both tissues were consistent with lipomas. After 18 months of follow-up, the patient was free of symptoms and CT revealed that bronchiectasia remained in the superior segment of the left lower lobe; however, no mass lesion was present in the left bronchus. Conclusions This case suggests that an endobronchial lipoma can present as multiple lesions, and both proximal and distal types can simultaneously occur in the same patient. Thus, these findings help us further understand the biology of endobronchial lipomas.
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Affiliation(s)
- Shunjin Zhao
- Department of Respiratory Medicine, Lanxi People's Hospital, No. 1359, Xishan Road, Lanxi, Jinhua, 321100, Zhejiang Province, China.
| | - Yuexiang Shui
- Department of Respiratory Medicine, Lanxi People's Hospital, No. 1359, Xishan Road, Lanxi, Jinhua, 321100, Zhejiang Province, China
| | - Zhong Dai
- Department of Respiratory Medicine, Lanxi People's Hospital, No. 1359, Xishan Road, Lanxi, Jinhua, 321100, Zhejiang Province, China
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8
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Griffeth EM, Whitson B, Huard D, Brown BR. Endobronchial Lipoma: Case Report and Literature Review. Am J Med Sci 2020; 361:111-117. [PMID: 32807376 DOI: 10.1016/j.amjms.2020.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/02/2020] [Accepted: 07/09/2020] [Indexed: 10/23/2022]
Abstract
Endobronchial lipomas are rare benign tumors that can cause bronchial obstruction resulting in significant symptoms and post-obstructive parenchymal damage. Accurate diagnosis and treatment are essential to avoid unnecessary morbidity and mortality in these patients. We describe one case of endobronchial lipoma at our institution and include a literature review of endobronchial lipoma cases reported during the time period 2003-2018. Treatment has shifted towards bronchoscopic management and away from surgery for the majority of patients; 64.3% of patients in this review had their lipoma resected bronchoscopically, compared to 30% or less in reviews as recent as 2003. Notably, in cases reported since 2010, 72.7% of cases were managed bronchoscopically. Recurrence rates are low following both bronchoscopic and surgical resection.
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Affiliation(s)
- Elaine M Griffeth
- College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
| | - Brian Whitson
- Integris Pulmonology Associates of Enid, Enid, Oklahoma
| | - David Huard
- Department of Radiological Sciences, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma
| | - Brent R Brown
- Department of Internal Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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9
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Gonin F. [Bronchial laser]. Rev Mal Respir 2018; 36:121-125. [PMID: 30318430 DOI: 10.1016/j.rmr.2017.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 01/07/2017] [Indexed: 11/25/2022]
Affiliation(s)
- F Gonin
- Service de chirurgie thoracique et transplantation pulmonaire, unité d'endoscopie interventionnelle, hôpital Foch, 92150 Suresnes, France.
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10
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Rotolo N, Cattoni M, La Rosa S, Imperatori A. A Rare Case of Incidental Tracheal Lipoma. Arch Bronconeumol 2018; 54:630-632. [PMID: 29803520 DOI: 10.1016/j.arbres.2018.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/27/2018] [Accepted: 02/28/2018] [Indexed: 10/16/2022]
Affiliation(s)
- Nicola Rotolo
- Center for Thoracic Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
| | - Maria Cattoni
- Center for Thoracic Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Stefano La Rosa
- Service of Clinical Pathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland
| | - Andrea Imperatori
- Center for Thoracic Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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11
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Flores-Franco RA, González-Calzadillas LF, Cota-Castro S. Successful Endoscopic Resection of an Endobronchial Lipoma Using a Percutaneous Gastrostomy Snare Device. Arch Bronconeumol 2018; 54:235-236. [DOI: 10.1016/j.arbres.2017.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/02/2017] [Accepted: 10/21/2017] [Indexed: 11/26/2022]
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12
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Bansal S, Utpat K, Desai U, Joshi JM. Endobronchial lipoma with tuberculosis: A solitary coetaneousness. Lung India 2018; 35:90-91. [PMID: 29319046 PMCID: PMC5760881 DOI: 10.4103/lungindia.lungindia_319_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Sameer Bansal
- Department of Pulmonary Medicine, T. N. Medical College, B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
| | - Ketaki Utpat
- Department of Pulmonary Medicine, T. N. Medical College, B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
| | - Unnati Desai
- Department of Pulmonary Medicine, T. N. Medical College, B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
| | - Jyotsna M Joshi
- Department of Pulmonary Medicine, T. N. Medical College, B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
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13
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Scarlata S, Fuso L, Lucantoni G, Varone F, Magnini D, Antonelli Incalzi R, Galluccio G. The technique of endoscopic airway tumor treatment. J Thorac Dis 2017; 9:2619-2639. [PMID: 28932570 DOI: 10.21037/jtd.2017.07.68] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
More than half of primary lung cancers are not resectable at diagnosis and 40% of deaths may be secondary to loco-regional disease. Many of these patients suffer from symptoms related to airways obstruction. Indications for therapeutic endoscopic treatment are palliation of dyspnea and other obstructive symptoms in advanced cancerous lesions and cure of early lung cancer. Bronchoscopic management is also indicated for all those patients suffering from benign or minimally invasive neoplasm who are not suitable for surgery due to their clinical conditions. Clinicians should select cases, evaluating tumor features (size, location) and patient characteristics (age, lung function impairment) to choose the most appropriate endoscopic technique. Laser therapy, electrocautery, cryotherapy and stenting are well-described techniques for the palliation of symptoms due to airway involvement and local treatment of endobronchial lesions. Newer technologies, with an established role in clinical practice, are endobronchial ultrasound (EBUS), autofluorescence bronchoscopy (AFB), and narrow band imaging (NBI). Other techniques, such as endobronchial intra-tumoral chemotherapy (EITC), EBUS-guided-transbronchial needle injection or bronchoscopy-guided radiofrequency ablation (RFA), are in development for the use within the airways. These endobronchial interventions are important adjuncts in the multimodality management of lung cancer and should become standard considerations in the management of patients with advanced lung cancer, benign or otherwise not approachable central airway lesions. We aimed at revising several endobronchial treatment modalities that can augment standard antitumor therapies for advanced lung cancer, including rigid and flexible bronchoscopy, laser therapy, endobronchial prosthesis, and photodynamic therapy (PDT).
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Affiliation(s)
- Simone Scarlata
- Geriatrics, Unit of Respiratory Pathophysiology and Thoracic Endoscopy, Campus Bio Medico University and Teaching Hospital, Rome, Italy
| | - Lello Fuso
- Bronchoscopy and Pneumology Unit, Catholic University, Rome, Italy
| | | | - Francesco Varone
- Bronchoscopy and Pneumology Unit, Catholic University, Rome, Italy
| | - Daniele Magnini
- Bronchoscopy and Pneumology Unit, Catholic University, Rome, Italy
| | - Raffaele Antonelli Incalzi
- Geriatrics, Unit of Respiratory Pathophysiology and Thoracic Endoscopy, Campus Bio Medico University and Teaching Hospital, Rome, Italy
| | - Gianni Galluccio
- Unit of Thoracic Endoscopy, San Camillo Forlanini Hospital, Rome, Italy
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14
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Dy RV, Patel S, Harris K, Mador MJ. Endobronchial lipoma causing progressive dyspnea. Respir Med Case Rep 2017; 22:95-97. [PMID: 28736696 PMCID: PMC5508497 DOI: 10.1016/j.rmcr.2017.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 07/05/2017] [Accepted: 07/05/2017] [Indexed: 12/16/2022] Open
Abstract
We describe a 63-year-old male who presented with progressive exertional dyspnea, post-obstructive pneumonia and chest CT findings of an endobronchial lesion. Bronchoscopy revealed an endobronchial lipoma, which was resected using snare electrocautery. Complete resolution of the patient's symptoms was noted following bronchoscopic resection.
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Affiliation(s)
- Rajany V. Dy
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University at Buffalo, State University of New York, USA
- Corresponding author.
| | - Sumit Patel
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University at Buffalo, State University of New York, USA
| | - Kassem Harris
- Department of Thoracic Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - M. Jeffery Mador
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University at Buffalo, State University of New York, USA
- Western New York Veterans Administration Healthcare System, 3495, Bailey Avenue, Buffalo, NY, USA
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15
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Piton N, Angot É, Marguet F, Sabourin JC. HMGA2 immunostaining is a straightforward technique which helps to distinguish pulmonary fat-forming lesions from normal adipose tissue in small biopsies: a retrospective observational study about a series of 13 lung biopsies. Diagn Pathol 2017; 12:21. [PMID: 28228139 PMCID: PMC5322620 DOI: 10.1186/s13000-017-0603-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/13/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND A tracheobronchial lesion observed during an endoscopic examination is usually sampled by the pulmonologist and sent to the pathologist for microscopic examination. Adipocytes may be observed in the lamina propria of tracheobronchial biopsies, which may complicate diagnosis of sampled lesions because these adipose cells may be part of the lesion (lipoma or pulmonary hamartoma), but may also be a normal component of the bronchial mucosa. Because endoscopic samples frequently miss their target, adipocytes observed in such biopsies usually lead to uncertainty regarding diagnosis. Both pulmonary hamartomas and lipomas have a high frequency of translocations involving HMGA2, resulting in over expression of the fusion protein. The literature suggests that only 31% of tracheobronchial lipomas are correctly diagnosed on biopsy, sometimes leading to unnecessary aggressive surgical resection. METHODS We performed retrospective study of tracheo-bronchial biopsies containing adipocytes using HMGA2 immunostaining in order to define their nature and to assess the diagnostic utility of this marker. RESULTS In total, 13 lesions biopsied in 12 patients and containing adipocytes were immunostained for HMGA2. Nuclear immunostaining was detected in 7 out of the 13 lesions (54%), allowing us to diagnose a lipoma or hamartoma. CONCLUSION HMGA2 immunostaining is an affordable and straightforward technique for accurate description of biopsies containing adipose cells. When positive, a diagnosis of benign adipose lesion can be made with confidence since well-differentiated liposarcomas have never been described in the tracheobronchial tree. Our work enabled us to diagnose a benign adipose lesion in 54% of cases, above the rate of 31% reported in the literature, based solely on morphological analysis. Overall, HMGA2 immunostaining could help pathologists to provide accurate diagnosis of tracheobronchial adipose lesions, leading to conservative treatment, for the overall benefit of patients.
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Affiliation(s)
- Nicolas Piton
- Department of Pathology, Rouen University Hospital, F 76 000 Rouen, France.
| | - Émilie Angot
- Department of Pathology, Rouen University Hospital, F 76 000 Rouen, France
| | - Florent Marguet
- Department of Pathology, Rouen University Hospital, F 76 000 Rouen, France
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16
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Wu Z, Wan H, Shi M, Li M, Wang Z, Yang C, Gao W, Li Q. Bronchoscopic resection of bronchial angiolipoma: A rare case report. Mol Clin Oncol 2017; 5:850-852. [PMID: 28101361 DOI: 10.3892/mco.2016.1069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 10/20/2016] [Indexed: 11/06/2022] Open
Abstract
Angiolipoma is a rare benign tumor that most commonly occurs in the extremities and trunk. Angiolipomas originating in the bronchial tree are extremely rare. To the best of our knowledge, only one such case, confined to the bronchus intermedius, has been reported to date. The present study describes the case of an asymptomatic 74-year-old man with a yellowish round mass incidentally discovered at the orifice of the right lower bronchus during a routine health check. The tumor originated from the membranous part of the right inferior bronchus. Using a high-frequency electric snare and argon plasma coagulation under general anesthesia, successful bronchoscopic resection of the tumor was performed. At 15 months after the surgery, the patient remained recurrence- and symptom-free.
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Affiliation(s)
- Zhiqiang Wu
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Hongli Wan
- Department of Gynecology and Obstetrics, Sichuan Provincial Communications Department Highway Bureau Hospital, Chengdu, Sichuan 611731, P.R. China
| | - Min Shi
- Department of Pathology, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Ming Li
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Zhanpeng Wang
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Caixia Yang
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Wei Gao
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Qingxin Li
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
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Endoscopic treatment of primary benign central airway tumors: Results from a large consecutive case series and decision making flow chart to address bronchoscopic excision. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2015; 41:1437-42. [PMID: 26329785 DOI: 10.1016/j.ejso.2015.08.157] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/15/2015] [Accepted: 08/13/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Benign tracheo-bronchial neoplasms are rare, but potentially dangerous conditions with life threatening consequences. Tumor removal should be pursued by methods minimizing the procedural stress. The role of endoscopic treatment, as an alternative to open surgery, remains controversial. OBJECTIVES report the twelve-years endoscopic experience in Rome, Italy. Fifty-seven benign tracheo-bronchial tumors were diagnosed and 130 tracheo-bronchial resections by rigid bronchoscopy performed. METHODS we identified histotypes associated with higher recurrence rate and assessed their relationship with gender, age and tracheo-bronchial location. We provided data on safety and complications and suggested a decision making flow chart to address the patients to endoscopic resection. RESULTS complete eradication after a single procedure without recurrence at 2 years was obtained in 63.1% of cases (36/57). Need of a second intervention within few months but no further recurrence at follow up was seen in a further 8.8% (5/57). Histotypes associated with recurrence were papillomas and inflammatory polyp. Seven patients (12.3%) were addressed to surgery because of multiple recurrence. Ten patients (17.5%) were lost at follow up. In case of recurrence, the bronchial biopsy was always repeated and no malignant transformation was observed. No major complications, pneumothorax or pneumomediastinum occurred. CONCLUSIONS endoscopic treatment of benign tracheo bronchial tumors is safe and effective, provided that the procedure is carefully and systematically planned. The rate of eradication is satisfactory and the incidence of complications negligible. This will encourage this approach as first line treatment especially in patients, frequently elderly people, having increased surgical risk due to concomitant respiratory failure or major comorbidities.
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18
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Multiphasic multidetector computed tomography study of a rare tracheal tumor: granular cell tumor. Case Rep Pulmonol 2014; 2014:807430. [PMID: 25548708 PMCID: PMC4274649 DOI: 10.1155/2014/807430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 11/18/2014] [Indexed: 11/17/2022] Open
Abstract
Our aim is to present the case report of a woman affected by tracheal granular cell tumor analysed by multiphasic contrast-enhanced multidetector CT.
The tumor presents as polypoid lesion (diameter 13 mm), with smooth and well-defined margins, elevated contrast enhancement in arterial phase, and a modest release of contrast in venous phase. This pattern is quite different from the other tracheal tumours.
We have performed a comprehensive review of literature to assess all cases of granular cell tumors of the trachea; only 40 cases are reported. Of these, no one focused on the contrast enhancement aspect, so our work is the first showing a specific pattern in multidetector computed tomography (MDCT) of the tracheal granular cell tumour and may help in differential diagnosis.
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Pourabdollah M, Shamaei M, Karimi S, Karimi M, Kiani A, Jabbari HR. Transbronchial lung biopsy: the pathologist's point of view. CLINICAL RESPIRATORY JOURNAL 2014; 10:211-6. [PMID: 25185518 DOI: 10.1111/crj.12207] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/04/2014] [Accepted: 08/27/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS The efficacy of flexible cryoprobe in providing high-quality tissue specimens through bronchoscopy for making a diagnosis remains debatable. In this study, we have compared the diagnostic yield of cryoprobe with conventional sampling by forceps. METHODS Forty-one patients scheduled to undergo transbronchial lung biopsy (TBLB) in a pulmonary hospital in Tehran, Iran. Each patient underwent conventional TBLB and flexible cryoprobe TBLB (FCLB) sequentially. Specimen adequacy was defined by the presence of at least 50 alveolar spaces or a positive diagnostic yield. Adequacy of specimens, number and percentage of alveolar spaces without artifact, type of artifact, presence of bronchiolar structures and the diagnosis made based on the results of the two methods separately were compared. RESULTS The mean values of tissue section area obtained by forceps and cryoprobe were 6 mm(2) [standard deviation (SD) ± 6.7] and 22 mm(2) (SD ± 19.1), respectively (P < 0.001). Specimens were adequate in 26 cases of conventional TBLB and 40 cases of FCLB (P < 0.001). Of adequate specimens, 14 samples obtained by TBLB and 28 samples obtained via FCLB were diagnostic. A significant difference was also detected between diagnostic and non-diagnostic specimens (P = 0.04). Frequency of specimens with >75% artifact-free lung parenchyma was significantly higher in FCLB method. CONCLUSION FCLB method provides larger tissue samples with better quality compared with TBLB. Higher-quality specimens are associated with less artifact and higher diagnostic yield. Multisite randomized trials are required to improve our knowledge about the benefits and indications of TBLB with cryoprobe.
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Affiliation(s)
- Mihan Pourabdollah
- Pediatric Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Shamaei
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shirin Karimi
- Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Karimi
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arda Kiani
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Jabbari
- Tracheal Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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20
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Harris K, Dhillon S, Huang M, Kumar A, Qiu J. Endobronchial lipoma: bronchoscopy, imaging and pathology. Ther Adv Respir Dis 2014; 8:162-4. [DOI: 10.1177/1753465814548190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kassem Harris
- Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14623, USA
| | - Samjot Dhillon
- Department of Medicine Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Miriam Huang
- Department of Thoracic Surgery Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Abhishek Kumar
- Department of Pathology Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Jingxin Qiu
- Department of Pathology Roswell Park Cancer Institute, Buffalo, NY, USA
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21
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Sivapalan P, Gottlieb M, Christensen M, Clementsen PF. An obstructing endobronchial lipoma simulating COPD. Eur Clin Respir J 2014; 1:25664. [PMID: 26557238 PMCID: PMC4629720 DOI: 10.3402/ecrj.v1.25664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 08/19/2014] [Indexed: 12/01/2022] Open
Abstract
Endobronchial lipomas are rare benign tumors of the respiratory tract. Bronchial occlusion may cause parenchymal damage and lead to a misdiagnosis of chronic obstructive pulmonary disease or malignancy. Therefore, both accurate diagnosis and radical treatment of endobronchial lipomas are essential. We describe the case of a 61-year-old man with a history of smoking (40 pack years), dyspnea in exertion, and cough during the past 6 months due to an endobronchial lipoma. Chest computed tomographic (CT) scan revealed a circumscribed polypoid lesion partially obstructing the left lower lobe. The endobronchial lipoma was removed by flexible bronchoscopy, and the patient had complete resolution of symptoms following the procedure. Flexible bronchoscopy was normal at the 3-month follow-up. In addition, clinical characteristics, diagnosis, and treatment of endobronchial lipomas are discussed.
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Affiliation(s)
- Pradeesh Sivapalan
- Department of Internal Medicine, Copenhagen University Hospital, Roskilde, Denmark
| | - Magnus Gottlieb
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark
| | - Merete Christensen
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark
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22
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Wang H, Du Z, Li A, Song J. Surgical treatment of an endobronchial lipoma obstructing the right upper bronchus: Imaging features with pathological correlation. Pak J Med Sci 2014; 29:1447-9. [PMID: 24550972 PMCID: PMC3905392 DOI: 10.12669/pjms.296.3708] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 09/10/2013] [Indexed: 11/15/2022] Open
Abstract
Endobronchial lipomas are rare benign unusual tumors of the respiratory tract. We describe a 65-year-old Chinese man with a history of cough due to an endobronchial tumor. The endobronchial biopsy was not excisional and was unable to evaluate the whole tumor. Then the mass was successfully resected via a right lateral thoracotomy. The histopathological diagnosis confirmed a benign lipoma arising from the membranous trachea. His CT features and fiberoptic bronchoscopic findings are shown along with the pathological results. In describing the management of this case, we stress that the clinical treatment of such tumors should be individualized according to the characteristics of each patient and mass.
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Affiliation(s)
- Haiyong Wang
- Haiyong Wang, MD, Department of Cardiothoracic Surgery, Affiliated Hospital of Guilin Medical College, Guilin 541001, China
| | - Zhenzong Du
- Zhenzong Du, MD, Department of Cardiothoracic Surgery, Affiliated Hospital of Guilin Medical College, Guilin 541001, China
| | - Angui Li
- Angui LI, MD, Department of Cardiothoracic Surgery, Affiliated Hospital of Guilin Medical College, Guilin 541001, China
| | - Jianfei Song
- Jianfei Song, MD, Department of Cardiothoracic Surgery, Affiliated Hospital of Guilin Medical College, Guilin 541001, China
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23
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Lynch S, Halfacree Z, Desmas I, Cahalan SD, Keenihan EK, Lamb CR. Pulmonary lipoma in a dog. J Small Anim Pract 2013; 54:555-8. [PMID: 23724782 DOI: 10.1111/jsap.12096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Revised: 04/09/2013] [Accepted: 04/29/2013] [Indexed: 11/26/2022]
Abstract
An eight-year-old, neutered, male German short-haired pointer was presented for a chronic cough and an intrathoracic mass. Computed tomography revealed a mass with low attenuation in the right caudal lung lobe that invaded the principal bronchi. The mass was removed by right caudal and accessory lung lobectomy. The histopathological diagnosis was pulmonary lipoma. The clinical signs resolved following surgery. There was no evidence of recurrence or de novo lesions on computed tomography performed 12 months post-surgery. To the authors' knowledge, this is the first report of a pulmonary lipoma in a dog.
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Affiliation(s)
- S Lynch
- Department of Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA; Department of Pathology and Pathogen Biology (Cahalan), The Royal Veterinary College, Hawkshead Lane, North Mymms,Hertfordshire, AL9 7TA
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24
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Yun SC, Na MJ, Choi E, Kwon SJ, Lee SJ, Oh SH, Cha EJ, Son JW. Successful removal of endobronchial lipoma by flexible bronchoscopy using electrosurgical snare. Tuberc Respir Dis (Seoul) 2013; 74:82-5. [PMID: 23482342 PMCID: PMC3591544 DOI: 10.4046/trd.2013.74.2.82] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Revised: 07/03/2012] [Accepted: 07/20/2012] [Indexed: 11/26/2022] Open
Abstract
A 62-year-old man with a chronic cough presented with atelectasis of the left upper lobe on chest X-ray. Chest computed tomography showed an atelectasis in the left upper lobe with bronchial wall thickening, stenosis, dilatation, and mucoid impaction. We performed bronchoscopy and found a well-circumscribed mass on the left upper lobe bronchus. The mass was removed by flexible bronchoscopy using an electrosurgical snare and diagnosed with lipoma. An endobronchial lipoma is a rare benign tumor that can be treated by a surgical or endoscopic approach. We report the successful removal of endobronchial lipoma via flexible bronchoscopic electrosurgical snare.
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Affiliation(s)
- Seong Cheol Yun
- Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
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Rodrigues AJ, Coelho D, Dias Júnior SA, Jacomelli M, Scordamaglio PR, Figueiredo VR. Minimally invasive bronchoscopic resection of benign tumors of the bronchi. J Bras Pneumol 2012; 37:796-800. [PMID: 22241038 DOI: 10.1590/s1806-37132011000600014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Accepted: 09/06/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Primary benign tumors of the trachea and main bronchi are uncommon. Interventional bronchoscopy allows the diagnosis and the treatment of some of these lesions. METHODS We reviewed four cases endoscopically treated at our institution. RESULTS Two patients had hamartoma, and two patients had endobronchial lipoma. In all of the cases, the interventional technique for the resection was the use of a polypectomy snare and electrocautery. The only complication reported was one episode of bronchospasm. CONCLUSIONS Minimally invasive bronchoscopic resection is a safe, effective method for treating selected benign tumors of the main airway and has a low complication rate.
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Affiliation(s)
- Ascedio Jose Rodrigues
- Respiratory Endoscopy Department, University of São Paulo School of Medicine Hospital das Clínicas, São Paulo, Brazil.
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26
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Madan K, Agarwal R, Bal A, Gupta D. Bronchoscopic management of a rare benign endobronchial tumor. REVISTA PORTUGUESA DE PNEUMOLOGIA 2012; 18:251-4. [PMID: 22463875 DOI: 10.1016/j.rppneu.2012.02.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Accepted: 12/05/2011] [Indexed: 11/30/2022] Open
Abstract
Benign endobronchial tumors are uncommon. Bronchoscopic removal is the preferred modality of treatment although surgery may be required in some cases. Rigid bronchoscopy is usually recommended in the management of these tumors. However, flexible bronchoscopy is also used in many centers. We present a case of endobronchial lipoma, where an unusual complication during flexible bronchoscopic resection using snare forceps necessitated urgent rigid bronchoscopy. This case highlights the importance of rigid bronchoscopy in the management of endobronchial tumors. We believe that with a large benign endobronchial tumor in tracheal or main-stem bronchus, physicians should initially employ rigid bronchoscopy, switching to flexible if more peripheral treatment is required.
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Affiliation(s)
- K Madan
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
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27
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An Endobronchial Lipoma Successfully Resected by High-frequency Electric Snare. J Bronchology Interv Pulmonol 2012. [DOI: 10.1097/lbr.0b013e31823fa944] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Endobronchial lipoma: an unusual cause of bronchial obstruction. Case Rep Med 2011; 2011:939808. [PMID: 21969834 PMCID: PMC3182831 DOI: 10.1155/2011/939808] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Revised: 07/30/2011] [Accepted: 07/31/2011] [Indexed: 11/25/2022] Open
Abstract
Endobronchial lipoma is a rare benign tumor. It is difficult to differentiate benign endobronchial lipoma from their malignant counterparts, as their symptoms and complications are almost alike. Here, we describe the clinical and radiological features of EL in two cases. Multislice CT (MSCT) may play an important role in the diagnosis for EL.
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29
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Successful bronchoscopic cryorecanalization in a case of endobronchial lipoma. DIAGNOSTIC AND THERAPEUTIC ENDOSCOPY 2011; 2011:845686. [PMID: 21789029 PMCID: PMC3140038 DOI: 10.1155/2011/845686] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 03/28/2011] [Accepted: 04/04/2011] [Indexed: 11/17/2022]
Abstract
Endobronchial lipomas are rare benign tumors; less than 150 cases have been reported so far. Bronchial occlusion usually leads to a misdiagnosis of asthma/COPD or malignancy. We report the case of a 67-year-old man with a history of heavy smoking (100 pack years), dyspnea on exertion, cough, and malaise who was treated for pneumonia for three weeks. Due to nonresolving atelectasis of the superior segment of the right lower lobe, a malignant endobronchial tumor was suspected. Rigid bronchoscopy with cryorecanalization led to both the definite histopathological diagnosis of endobronchial lipoma and the reopening of an endoluminal airway obstruction during one procedure.
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30
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Zehani-Kassar A, Ayadi-Kaddour A, Marghli A, Ridene I, Kilani T, El Mezni F. [Clinical characteristics of resected bronchial hamartoma. Study of seven cases]. Rev Mal Respir 2011; 28:647-53. [PMID: 21645835 DOI: 10.1016/j.rmr.2010.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 12/18/2010] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Endobronchial hamartoma is a benign tumour derived from peribronchial mesenchymal tissue. It is a form of intrapulmonary hamartoma and can cause irreversible pulmonary destruction due to bronchial obstruction. Early diagnosis and treatment is very important and endoscopic treatment is usually the first choice. In cases in which prolonged bronchial obstruction has produced irreversible lung destruction surgical, resection of the tumour is necessary. The aim of this study is to describe the clinicopathological characteristics of resected endobronchial hamartoma. PATIENTS AND METHODS Seven cases of endobronchial hamartoma, diagnosed in our institution between January 1995 and December 2009, were reviewed retrospectively. RESULTS The patient population consisted of four males and three females with mean age of 53.7 years (41-68 years). The most frequent clinical presentation was obstructive pneumonia. Endoscopy and imaging showed an endobronchial mass in most cases. Surgical treatment consisted of atypical resection in one case, lobectomy in five cases and pneumonectomy in one case. Tumour size ranged between 0.5 and 3.5 cm. The diagnosis was confirmed in all cases by histological examination. The outcome was favorable in all cases. CONCLUSION Endoscopic techniques are effective for the diagnosis and treatment of endobronchial hamartochondroma. Treatment should be prompt to prevent irreversible lung damage due to chronic obstruction and suppuration, in which case, pulmonary resection may be necessary.
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Affiliation(s)
- A Zehani-Kassar
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital Abderrahman-Mami, Ariana, Tunisie.
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31
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Sardón O, Marhuenda C, Santiago M, Torán N, Korta J, Corcuera P, Barceló C, Pérez-Yarza EG. [Endobronchial chondromesenchymal hamartoma]. An Pediatr (Barc) 2010; 72:263-6. [PMID: 20206588 DOI: 10.1016/j.anpedi.2009.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Accepted: 12/14/2009] [Indexed: 10/19/2022] Open
Abstract
Primary lung tumours are uncommon in childhood. Among these tumours, endobronchial masses are even less common and, among benign tumours, inflammatory pseudotumours and hamartomas have the highest incidence in children. We present the case of a 2.5-year-old girl with a left endobronchial chondromesenchymal hamartoma with obstruction of 90% of the bronchial lumen. Complete resection of the endobronchial mass was performed by rigid bronchoscopy and application of topical mitomycin C. After tumour resection and a 12-month follow-up, the patient has shown a favourable outcome with immediate disappearance of respiratory symptoms. Successive fibreoptic bronchoscopies have shown no residual tumour.
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Affiliation(s)
- O Sardón
- Hospital Donostia, Osakidetza, San Sebastián, España.
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Abstract
Endobronchial lipoma is a rare benign lung tumor. Here we present two cases. One case is the first report of the association of and endobronchial lipoma with a hilar lipoma. We discuss the epidemiology, difficulties in establishing the diagnosis, and the management of this rare condition.
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