A Solitary Bronchial Papilloma with Malignant Changes.

Abstract

Wedescribe a case of solitary papilloma of the bronchus and provide a review of 38 similar cases reported in Japan. A 70-year-old man complained of cough and sputum. Chest X-rays and CT scans revealed atelectasis of the right middle lobe. On bronchoscopy, a polypoid tumor was found at the orifice of the bronchus of the right middle lobe. The tumor was histologically diagnosed as a squamous papilloma with moderateatypia. Becauseof elevated tumormarkers and the reported high incidence of malignant changes in papillomas, the tumor was endoscopically resected by electrosurgical snare. While this procedure resulted in improvement of atelectasis, the chest CT taken subsequently revealed a mass adjacent to the resected polypoid tumor in the middle lobe bronchus. Percutaneous needle biopsy followed by histopathological examination confirmed the tumor to be a squamous cell carcinoma. Only three cases of malignant changes in papillomas have been previously reported in Japan. Electrosurgical snare, which allows the identification of tissue at the tumor base, should be the treatment of choice rather than YAGlaser surgery. (Internal Medicine 40: 56-60, 2001)

Solitary Bronchial Papilloma with Malignant Degeneration Presenting with Bronchiectasis and Hemoptysis

“…There seems to be a very close relationship between this type of papilloma and smoking habits. Passive smoking also needs to be taken into account in female cases [2]. Our case was also a heavy smoker.…”

“…The age distribution of the cases is in a very wide range of 22 to 80 years (mean, 58.3 years) and the highest incidence of solitary bronchial papilloma is seen in the 6th decade, and our patient was rather old 73 years. These tumors are six times more common in men than in women [1,2]. Most tumors were located in the segmental or more central bronchi (86%), while the remainder were in subsegmental or peripheral bronchi.…”

“…Furthermore, a solitary bronchial papilloma without coexistent pharyngeal papilloma is much rarer. Previous studies have suggested that this type of benign tumor is liable to be complicated by transformation to squamous cell carcinoma at its base and it should rather be considered as a precancerous lesion [2]. We presented a case of solitary endobronchial papilloma which was subsequently complicated by bronchiectasis, hemoptysis, and malignant degeneration.…”

“…The incidence of this tumor is reported to be only five cases in 15000 bronchoscopies [1]. Bronchial squamous papilloma, a benign tumor originating from squamous epithelial cells, accounts for 0.38% of all lung tumors [2]. Furthermore, a solitary bronchial papilloma without coexistent pharyngeal papilloma is much rarer.…”

Unusual lung tumours: an illustrated review of CT features suggestive of this diagnosis

“…Most of these lesions are histologically benign; however, a few cases have been documented which contain or are closely associated with carcinoma in situ and invasive squamous cell carcinoma [31] . Primary pulmonary carcinoid is a tumour of neuroendocrine origin and has a predilection for the airways [32] .…”