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      Polypoid Endobronchial Lung Cyst with Bronchoscopic Removal : A Case Report

      case-report

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          Abstract

          Pulmonary bronchogenic cyst in adults is rare and the typical appearance is a sharply circumscribed, round or oval nodule or mass, usually in the medial third of the lungs. Bronchial polyps are rare histopathologically distinct nonneoplastic endobronchial lesions and are classified as multiple papillomas, solitary papillomas, and inflammatory polyps. We herein report a patient with polypoid endobronchial lung cyst. A 68-yr-old woman presented with a discomfort and pain in the right upper chest of four weeks??duration. Chest radiography revealed a cystic lesion in the right upper lung. Computed tomography revealed a 4×5 cm sized large cyst. Neither enlarged mediastinal lymph nodes nor extrabronchial involvements were observed. Flexible bronchoscopy revealed a peduncular polyp about 2 cm in length originating from the anterior segment of right upper lung. After bronchoscopic removal of polyp, cystic lesion of the right upper lung disappeared.

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          Bronchogenic cysts of the mediastinum.

          M Ribet, M Copin, B Gosselin (1995)
          During a 25-year period 69 patients whose ages ranged from 1 day to 64 years were treated for bronchogenic cyst of the mediastinum. The male-to-female sex ratio was 1:0.76. The cysts were symptomatic in 63.7%, compressive in 43.4%, and life threatening in 2.8% of cases. Symptoms and signs of compression were more frequent in infants and children than in adults. Such symptoms and signs were more dependent on the location of the cyst than on its volume. The preoperative diagnosis was wrong in 16% of cases. The cysts were approached through thoracotomy in 67 cases, including one conversion from thoracoscopy, and through cervicotomy and mediastinoscopy in one case each. The cysts opened into the respiratory tract in five cases. No communication with the esophageal lumen was observed. The cystic contents were apparently infected in three cases, but samples remained sterile at culture. There was one hospital death caused by a centrally located compressive cyst that was undiagnosed at thoracotomy. The postoperative morbidity rate was 13.4%. There were no further symptoms after operation in children, but five adults reported continuing pain or dyspnea. Resection of bronchogenic cysts is recommended because of uncertainties in diagnosis and in evolution.
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            Inflammatory bronchial polyps associated with asthma: resolution with inhaled corticosteroid.

            F Kuze, Michael D. Y. Kubo, A Niimi … (1995)
            In a 50 year old man who complained of cough and sputum, a small endobronchial tumour was found in the left main bronchus and was biopsied via bronchoscopy. The histological diagnosis was inflammatory polyp with marked infiltration of eosinophils. Six years later, the patient developed asthma. At the same time, another polyp was found in the posterior basal bronchus of the right lower lobe. The appearance of the first polyp was unchanged endoscopically and histologically. Inhalation of beclomethasone dipropionate, 200 micrograms b.i.d., was started and symptoms of asthma soon subsided. In addition, the two polyps regressed and eventually disappeared after one year of treatment. Inhaled corticosteroids, being noninvasive and relatively safe, appear to be a possible therapeutic option in inflammatory bronchial polyps, especially in cases where the patient has asthma as an underlying condition, or the polyps are small and their management is not urgent.
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              SOLITARY PAPILLOMA OF A BRONCHUS.

              J C Drennan, Kirsty A Douglas (1965)
              The cause of asthmatic attacks in a middle-aged man was disclosed and the relief of his symptoms achieved at one and the same time when he coughed up a tumour which proved to be a solitary bronchial papilloma. The pedicle of the tumour had ruptured as the result of infarction due to thrombosis in stromal blood vessels. Asthmatic attacks, stromal blood vessel thrombosis, and the coughing up of the tumour are three features which have not been reported in the few published accounts of this exceedingly rare bronchial tumour.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Korean Med Sci
                Journal ID (publisher-id): JKMS
                Title: Journal of Korean Medical Science
                Publisher: The Korean Academy of Medical Sciences
                ISSN (Print): 1011-8934
                ISSN (Electronic): 1598-6357
                Publication date (Print): October 2005
                Publication date (Electronic): 31 October 2005
                Volume: 20
                Issue: 5
                Pages: 892-894
                Affiliations
                Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Korea.
                [* ]Department of Pathology, Soonchunhyang University Hospital, Bucheon, Korea.
                [† ]Department of Radiology, Soonchunhyang University Hospital, Bucheon, Korea.
                Author notes
                Address for correspondence: Choon-Sik Park, M.D. Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 1174 Jung-dong, Wonmi-gu, Bucheon 420-021, Korea. Tel: +82.32-621-5105, Fax: +82.32-621-5016, mdcspark@ 123456hanmail.net
                Article
                DOI: 10.3346/jkms.2005.20.5.892
                PMC ID: 2779293
                PubMed ID: 16224170
                SO-VID: ec93976a-f156-4461-8a39-239b04d79e89
                Copyright © Copyright © 2005 The Korean Academy of Medical Sciences
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 07 July 2004
                Date accepted : 22 September 2004
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Medicine
                Keywords: polyp,lung disease,bronchus,bronchoscopy,bronchial cyst
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: polyp, lung disease, bronchus, bronchoscopy, bronchial cyst

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