SESSION TYPE: Airway Student/Resident Case Report Posters
PRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PM
INTRODUCTION: Endobronchial lipoma is an extremely rare benign pulmonary tumor. Different patients with endobrochial lipomas have varieties of clinical symptoms. Nowadays, therapeutic bronchoscopy have been replacing conventional surgery for the treatment of it.
CASE PRESENTATION: A 67-year-old man presented with cough and sputum for 2 months. A chest CT demonstrated atelectasis of the left up lobe, hydrothorax in the left thoracic cavity, and stenosis of the left up bronchus. Bronchoscopy showed a well defined, smooth tumor at the beginning of the right up bronchus(fig.1). APC resection was performed by endoscopy with no complications. Pathology confirmed the diagnosis of Endobronchial Lipoma (fig.2). Carbenin was then used for 20d. The patient was discharged 20d after admission and has been followed up for 2 year without symptoms. The chest CT (2 months late) showed that the sighs have been better.
DISCUSSION: Endobronchial lipomas originate from the adipose tissue that is normally present in the tracheobronchial wall, accounting for only 0.1% to 0.5% of all lung tumors. Depending on the location of the tumor, and the severity of bronchial obstruction, endobronchial lipomas present varieties of symptoms, including persistent cough, sputum, dyspnea, recurrent pneumonia, or even no symptoms. A large number of people had abnormal chest radiographic findings. The most common radiographic manifestation is atelectasis, obstructive pneumonia, and so on. Bronchoscopy can directly show the tumor, and transbronchial lung biopsy can final diagnosis the disease, although, because of the the submucosal growth of endobronchial lipomas, their detection rates are rather low. Nowadays, bronchoscopic resection has been considered as the first choice of treatment for bronchial lipoma. But there are still some limitations: First, there are some difficulties in obtaining the definitive diagnosis. Second, long-term atelectasis or pneumonia will also lead to some peripheral destructive lung diseases. Finally, there are technical problems in the treatment of completely obstructive endobronchial benign tumor.
CONCLUSIONS: Edobronchial lipomas are extremely rare lung benign tumors; they have varieties of symptoms, especially cough and atelectasis; chest radiographical examinations are chief diagnostic methods; bronchoscopy can not only be a diagnostic method, but also be a therapeutic method; using APC resection through bronchoscopic to remove the lipoma is a very efficacious therapeutic method.
1) Masashi M, Tadayuki O, Shinji A, Takeshi N, Masachika I, Naofumi S, et al. Endobronchial lipoma. Review of 64 cases reported in Japan. Chest. 2003;123:293-6.
2) MacArthur CGC, Cheung DLC, Spiro SG: Endobronchial lipoma: A review with four cases. Br J Dis Chest 71 :93-100,1977
DISCLOSURE: The following authors have nothing to disclose: Fanglei Liu, Enguo Chen, Kejing Ying
No Product/Research Disclosure InformationZhongshan Hospital Affiliated to Fudan University, Shanghai, China