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Endobronchial Lipoma
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Endobronchial Lipoma Sanjay Kumar, MCh, FRCS, Muhammad U. Rafiq, MBBS and Michael E. Cowen, FRCS ∗ East Yorkshire Heart Centre, Castle Hill Hospital, Hull HU16 5JQ, United Kingdom
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ndobronchial lipoma is a very rare benign lung tumour. It can cause bronchial obstruction, leading to extensive distal parenchymal damage. A 56-year-old gentleman presented with tightness in the chest and symptoms of lower respiratory tract infection. He underwent chest X-ray followed by a contrast enhanced computerised tomographic (CT) scan of the chest (Fig. 1A). Subsequently, he underwent a bronchscopy, which revealed a smooth polypoidal sessile mass in the apical segment of the right upper lobe bronchus (Fig. 1B). This mass was successfully removed
with a bronchoscope. The histology report was consistent with lipoma (Fig. 2A and B). The patient made a good postoperative recovery. This patient is added to the list of regular bronchoscopic surveillance. Endoscopic resection is a preferred therapeutic approach for this subgroup of patients. However, surgical therapy is indicated for patients who show the possibility of a complicated malignant tumour, who have destructive peripheral lung disease, who have extrabronchial growth, or who may have technical difficulties during the bronchoscopic procedure.
Figure 1. (A) Contrast enhanced CT of chest showing atelectatic changes in the right upper lobe, with bands from the upper right hilum to the periphery antero- and postero-laterally. A low attenuation filling defect (HU-120) with a medially convex border seen within the right upper lobe bronchus suggesting either a mucous plug or bronchial neoplasm. (B) Bronchoscpy showing endobronchial sessile polypoidal mass with smooth mucosal surface present at the ostia of the anterior segment of the right upper lobe bronchus.
Figure 2. Haematoxyllin and eosin section showing (A) respiratory epithelium overlying fibrous connective tissue and fat. Superficially the fibrous tissue resembles inflammatory granulation tissue showing an increase in vascularity and with a mild mixed acute and chronic inflammatory cell infiltrate. (B) The underlying adipose tissue shows adipocytes with marked variation in size. Received 17 May 2006; accepted 7 September 2006; available online 16 February 2007 ∗ Corresponding author. Tel.: +44 1482 623261; fax: +44 1482 623257.
E-mail address: [email protected] (S. Kumar).
1443-9506/04/$30.00 doi:10.1016/j.hlc.2006.09.013
Image
Endobronchial Lipoma Sanjay Kumar, MCh, FRCS, Muhammad U. Rafiq, MBBS and Michael E. Cowen, FRCS ∗ East Yorkshire Heart Centre, Castle Hill Hospital, Hull HU16 5JQ, United Kingdom
E
ndobronchial lipoma is a very rare benign lung tumour. It can cause bronchial obstruction, leading to extensive distal parenchymal damage. A 56-year-old gentleman presented with tightness in the chest and symptoms of lower respiratory tract infection. He underwent chest X-ray followed by a contrast enhanced computerised tomographic (CT) scan of the chest (Fig. 1A). Subsequently, he underwent a bronchscopy, which revealed a smooth polypoidal sessile mass in the apical segment of the right upper lobe bronchus (Fig. 1B). This mass was successfully removed
with a bronchoscope. The histology report was consistent with lipoma (Fig. 2A and B). The patient made a good postoperative recovery. This patient is added to the list of regular bronchoscopic surveillance. Endoscopic resection is a preferred therapeutic approach for this subgroup of patients. However, surgical therapy is indicated for patients who show the possibility of a complicated malignant tumour, who have destructive peripheral lung disease, who have extrabronchial growth, or who may have technical difficulties during the bronchoscopic procedure.
Figure 1. (A) Contrast enhanced CT of chest showing atelectatic changes in the right upper lobe, with bands from the upper right hilum to the periphery antero- and postero-laterally. A low attenuation filling defect (HU-120) with a medially convex border seen within the right upper lobe bronchus suggesting either a mucous plug or bronchial neoplasm. (B) Bronchoscpy showing endobronchial sessile polypoidal mass with smooth mucosal surface present at the ostia of the anterior segment of the right upper lobe bronchus.
Figure 2. Haematoxyllin and eosin section showing (A) respiratory epithelium overlying fibrous connective tissue and fat. Superficially the fibrous tissue resembles inflammatory granulation tissue showing an increase in vascularity and with a mild mixed acute and chronic inflammatory cell infiltrate. (B) The underlying adipose tissue shows adipocytes with marked variation in size. Received 17 May 2006; accepted 7 September 2006; available online 16 February 2007 ∗ Corresponding author. Tel.: +44 1482 623261; fax: +44 1482 623257.
E-mail address: [email protected] (S. Kumar).
1443-9506/04/$30.00 doi:10.1016/j.hlc.2006.09.013