Case Report: Massive Hemoptysis From a Spontaneously Regression Inflammatory Bronchial Polyp

Abstract

BackgroundBronchial inflammatory polyps are usually treated by surgical operation or with steroids and/or antibiotics, and it is quite rare that such polys spontaneously disappear without any treatment. This report shows a rare case with a bronchial inflammatory polyp which caused massive hemoptysis but spontaneously disappeared without any treatment.Case PresentationA 66-year-old man with type 2 diabetes mellitus and a history of cough and asthma suddenly developed massive hemoptysis while smoking and was brought to an emergency room in our institution. In bronchoscopy on admission, a polypoidal elevated lesion was observed in the left upper lobe bifurcation. Pulsatile hemorrhage from a polypoidal elevated lesion was observed upon stimulation of passage of the bronchoscope. Bronchoscopy performed 25 days after discharge showed no evidence of active bleeding and a tendency toward reduction of the elevated lesion. In bronchoscopy performed 106 days after the initial hospitalization, the bronchial inflammatory polyp completely disappeared.ConclusionsWe should bear in mind the possibility of spontaneous disappearance of bronchial inflammatory polyps causing some serious symptoms such as massive hemoptysis and repeated bloody sputum. Finally, we should select the best therapy for bronchial inflammatory polys based on each patient's background and conditions in clinical practice.

Successful excision of an inflammatory endobronchial polyp using biopsy forceps with improvement in FEV1 in a patient with allergic bronchopulmonary aspergillosis: A case report

“…The pathogenesis of IEPs is thought to be damage to the airway mucosa caused by a trigger, leading to increased vascular permeability, edema, inflammatory cell infiltration, and fibrosis, causing mucosal herniation into the bronchial lumen [ 2 , 5 ]. Infectious diseases such as influenza and tuberculosis, allergies affecting the airway mucosa, foreign bodies, smoking, trauma, surgical invasions, and respiratory conditions such as bronchial asthma, cystic fibrosis, and silicosis have been reported as triggers for polyp formation [ 1 , 2 , 6 , 7 ]. While detailed reports on ABPA with concurrent IEPs are lacking, the pathology obtained suggests that these two diseases may have developed independently; however, several factors contribute to their development.…”

“…IEPs can be treated using various approaches, including conservative treatment, pharmacotherapy, bronchoscopic forceps extraction, Nd-YAG laser cauterization, and surgery [ 1 ]. Cryobiopsy, which has become widespread in recent years, is a potential option.…”

“…Therefore, the appropriate treatment should be selected considering comorbidities. Conservative treatment has led to spontaneous resolution in 8% of cases [ 1 ]. Inhaled beclomethasone is effective for treating bronchial asthma in some cases [ 6 ].…”

“…Inflammatory endobronchial polyps (IEPs) are rare, benign bronchial tumors caused by infection, trauma, or chronic respiratory diseases [ [1] , [2] , [3] ]. Owing to insufficient data on IEPs, the management of patients with IEPs with comorbid chronic respiratory diseases presents diagnostic and therapeutic challenges.…”