Solitary endobronchial papillomas are among the rarest benign solitary neoplasms of the lung and little literature about them exists. Our purpose was to more precisely determine the frequency of solitary papillomas, the associated signs and symptoms, a possible predilection of location within in the airway tract, and the frequency of malignant degeneration.
We retrospectively reviewed the histopathology results of 36,780 bronchoscopic procedures in a 22 year interval (1986 –2008) from a single center serving as the only facility with bronchoscopy capabilities for about 2.5 million people in Northern Greece.
We found that 32 patients (0.00087%) had a documented solitary endobronchial papilloma, an incidence of 3.95 cases/105 patients/year. Twenty three were men (median age; 61 ± 16 years old) and 9 were women (median age; 44 ± 12,32 years old). The reported symptoms in these patients were cough in 18 (40.6%), hemoptysis in 11 (25%), dyspnea in 7 (21.8%), and fever in 5 (15,65%). The papillomas were located in the lingula in 12 patients (37,5%), along the trachea in 9 (28.15%), in the intermediate bronchus in 8 (25%). Each time in only 1 patient (3,1%) papillomas were found in the apical bronchus (B6) of the right lower lung lobe, in the superior lobe (B4) of the lingula, and in the anterior lobe bronchus (B8) of the left lower lung lobe.On histopathologic examination there was a predominance of squamous cell papillomas, which were found in 21 (65.6%%) patients. In five (15,65%) cases evidence of developing malignancy was seen. Surgical excision was the most frequent therapeutic intervention (in 30 cases, 93%).
Solitary endobronchial papillomas are some of the rarest benign tumors. In our population histologically the most frequent are the squamous cell papillomas which have a tendency to transform into malignancy. Cough and hemoptysis were the most common clinical findings.
Solitary endobronchial papillomas clinically and bronchoscopically mimic malignant central tumors. They have a tendency to grow in size in smokers and may at times transform into malignancy.
Stavros Tryfon, No Financial Disclosure Information; No Product/Research Disclosure Information