A 72-year-old woman was in good health until she experienced an episode of cough and minor hemoptysis that lasted a few days. These symptoms recurred after an interval of 6 weeks when the patient was seen in our clinic for the first time. The patient had no history of previous intubation or other intervention in the upper airways. On physical examination, a goiter was found, but the lungs and heart were normal. The results of hematologic and chemical laboratory tests were unremarkable, and the levels of thyrotropin, free triiodothyronine, and free thyroxine were normal. A CT scan of the chest showed an asymmetric nodular enlargement of both lobes of the thyroid gland with a locally narrowed and displaced trachea. Bronchoscopy revealed a polypoid tracheal tumor, 0.2 to 0.3 cm in size, with a hyperemic overlying mucosa 3 cm below the vocal cords (Fig 1
). The other parts of the trachea, which had a normal lumen, were unremarkable. With a flexible biopsy forceps, the tumor was completely removed, and the subsequent mild bleeding stopped a few minutes after the local instillation of adrenaline (0.1 mg/mL). Histologic examination revealed numerous capillaries arranged in a lobular pattern. The endothelial cells had a bland appearance, and occasional regular mitotic figures were present. The lobules were separated by fibrous stroma with mild accompanying inflammatory changes. The overlying epithelium was intact (Fig 2
). There were no signs of malignancy (eg, of invading thyroid cancer), and the diagnosis of an LCH was made. During the ensuing year, the patient remained completely asymptomatic. She had no associated LCH of the skin or oral cavity.