Bronchial Polyps Research Articles

Endobronchial inflammatory polyps

Endobronchial inflammatory polyps are one of the rarest benign bronchial tumors. Tumors of benign etiology are even rare. Inflammatory bronchial polyps are frequently solitary although rarely can be multifocal. We are presenting a rare case of multiple endobronchial inflammatory polyps presenting as pneumonia.

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

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 treatment of nasal polyps with low dose aspirin for asipirin sensitive patients

Aspirin-exacerbated respiratory disease (AERD) represents a severe form of chronic rhinosinusitis (CRS) characterized by nasal polyposis, bronchial asthma and aspirin intolerance. The following syndrome is difficult to manage. In this report, we present a case of hypersensitivity to acetylsalicylic acid (AsA) together with bronchial asthma and nasal polyps. This case proves that desensitization for aspirin is one of the alternative methods of treatment for nasal polyps and aspirin-induced asthma for people hypersensitive to aspirin.

Bronchial Fibroepithelial Polyp: A Rare and Challenging Diagnosis

Context: Bronchial fibroepithelial polyp is a very rare benign endobronchial tumor. Typically, it is a slow growing lesion, and the differential diagnosis includes other benign and malignant endobronchial tumors. Case Report: We report a case of a 75-year-old female who complained of intermittent productive cough. Computed tomography of the thorax showed a solid nodule with lobulated contours in the right main bronchus and subtotal atelectasis of the right lower lobe. Bronchoscopy with biopsy confirmed the diagnosis of a bronchial fibroepithelial polyp. Conclusion: This case is illustrative and demonstrates the importance of imaging methods and of histopathological correlation for the accurate diagnosis of this benign treatable lesion.

A Case of Mediastinal Tuberculous Lymphadenitis Presenting with Atelectasis and Bronchial Polyp Caused by Paradoxical Reaction

A Case of Mediastinal Tuberculous Lymphadenitis Presenting with Atelectasis and Bronchial Polyp Caused by Paradoxical Reaction

Death after Bronchoscopic Biopsy of a Pulmonary Artery Aneurysm Mimicking Bronchial Polyp

Pulmonary artery aneurysms (PAAs) are rare, and massive hemoptysis can lead to death if appropriate diagnosis and treatment is not provided. PAAs can be of congenital, acquired, or idiopathic origin, and the clinical symptoms are various. Among all reported cases, one-third of the patients died due to rupture. Optimal treatment or guidelines for PAAs remain uncertain. Herein, we report autopsy findings from a woman with PAA. The patient was taking medication for tuberculosis. On bronchoscopy, a polypoid lesion was found, suspected to be an inflammatory polyp. Biopsy was performed and massive bleeding into the airway occurred. The bleeding could not be controlled by bronchoscopic suction, and cardiac arrest occurred 30 minutes after biopsy; the patient subsequently died. Autopsy revealed a round, calcified PAA in the bronchus of the right middle lobe; the end of the PAA was torn. Hypovolemic signs, including weak postmortem lividity and pallor of the skin and conjunctivae, were observed. Visual inspection and histopathological examination of the right lung revealed tuberculosis and congestion. Cases related PAA are not uncommon, but autopsy cases of death occurring after biopsy of PAA mimicking bronchial polyps are rarely reported.

鼻腔内の炎症性ポリープを併発した気管支炎症性ポリープの 1 例

鼻腔内の炎症性ポリープを併発した気管支炎症性ポリープの 1 例

繰り返す喀血と限局性浸潤影により発見された炎症性気管支ポリープの 1 例

繰り返す喀血と限局性浸潤影により発見された炎症性気管支ポリープの 1 例

血清シフラが高値を示した気管支炎症性ポリープの 1 例

血清シフラが高値を示した気管支炎症性ポリープの 1 例

Endobronchial Neurilemmoma Mimicking a Bronchial Polyp

Neurilemmomas are relatively uncommon, slowly growing tumors which originate from Schwann cells. Intrathoracic neurilemmomas often occur in the chest wall and posterior mediastinum, but endobronchial neurilemmomas are exceedingly rare. These tumors in trachea or bronchus are usually detected by radiologic examinations, mostly computed tomography scan of chest. An 88-year-old man was admitted for management of pneumonia in left lower lobe and parapneumonic effusion. On bronchoscopic examination, there was a small polypoid nodule less than 1 cm in diameter mimicking an endobronchial inflammatory polyp at the bifurcation of the right anterior segmental bronchus and lateral segmental bronchus and under auto-fluorescence imaging, the nodule showed reddish brown area with defined margin. The bronchoscopic biopsy revealed that the bronchial nodule was endobronchial neurilemmoma. This is an interesting case of endobronchial neurilemmoma mimicking a bronchial polyp that is detected incidentally via bronchoscopy.

Effect of radiation dose and iterative reconstruction on lung lesion conspicuity at MDCT: Does one size fit all?

ObjectiveTo evaluate the effect of different acquisition parameters and reconstruction algorithms in lung lesions conspicuity in chest MDCT. MethodsAn anthropomorphic chest phantom containing 6 models of lung disease (ground glass opacity, bronchial polyp, solid nodule, ground glass nodule, emphysema and tree-in-bud) was scanned using 80, 100 and 120kVp, with fixed mAs ranging from 10 to 110. The scans were reconstructed using filtered back projection (FBP) and iterative reconstruction (IR) algorithms. Three blinded thoracic radiologists reviewed the images and scored lesions conspicuity and overall image quality. Image noise and radiation dose parameters were recorded. ResultsAll acquisitions with 120kVp received a score of 3 (acceptable) or higher for overall image quality. There was no significant difference between IR and FBP within each setting for overall image quality (p>0.05), even though image noise was significantly lower using IR (p<0.0001). When comparing specific lower radiation acquisition parameters 100kVp/10mAs [Effective Dose (ED): 0.238mSv] vs 120kVp/10mAs (ED: 0.406mSv) vs 80kVp/40mAs (ED: 0.434mSv), we observed significant difference in lesions conspicuity (p<0.02), as well as significant difference in overall image quality, independent of the reconstruction algorithm (p<0.02), with higher scores on the 120kV/10mAs setting. Tree-in-bud pattern, ground glass nodule and ground glass opacity required lower radiation doses to get a diagnostic score using IR when compared to FBP. ConclusionDesigning protocols for specific lung pathologies using lower dose acquisition parameters is feasible, and by applying iterative reconstruction, radiologists may have better diagnostic confidence to evaluate some lesions in very low dose settings, preserving acceptable image quality.

Large Cell Neuroendocrine Carcinoma Arising from the Left Main Bronchus

A 67-year-old man was referred to our hospital for a detailed medical examination of a bronchial polyp that was detected during chest computed tomography. Bronchoscopic examination revealed a tumor that almost occluded the main left bronchus. Nd-YAG laser treatment and tumor removal with biopsy forceps were conducted. On the basis of the histopathological and immunohistochemical features, large cell neuroendocrine carcinoma (LCNEC), T2aN0M0, stage IB was diagnosed. After induction chemotherapy with a combination of cisplatin and etoposide, a sleeve resection of the left main bronchus with telescoping bronchial anastomosis was performed. LCNEC typically occurs in the peripheral lung field, but here, we report a rare case of LCNEC arising from the left main bronchus.

Spontaneous Regression of a Bronchial Polyp Associated with Sarcoidosis

Spontaneous Regression of a Bronchial Polyp Associated with Sarcoidosis

Analgetikaintoleranz

The full clinical picture of aspirin intolerance - the association of aspirin-induced bronchial asthma, aspirin sensitivity and nasal polyps - has been described as Morbus Widal or later as the "Samter triad". Today the term Aspirin-exacerbated respiratory disease (AERD) is preferred to account for the progressive nature of this inflammatory airway condition with its unrelenting course even in the absence of non steroidal anti-inflammatory drugs (NSAID). This acquired idiosyncrasy appears to be related to an abnormal arachidonic acid metabolism. Epidemiological data suggests that 10% of all asthmatics do react with life-threatening asthma-attacks after the ingestion of aspirin (ASA) or other NSAID. Some asthmatics with nasal polyposis have been reported to suffer from aspirin intolerance. Although the exact mechanism is still unclear, it is unlikely that the pathogenesis is IgE-mediated. Patients often report chronic nasal obstruction, hyposmia, chronic rhinorrhoea, orbital edema and urticaria with flushing after the ingestion of NSAID. While a typical history and endoscopic findings can be suggestive of AERD, a definite diagnosis relies on appropriate challenge tests. AERD is often refractory to standard asthma treatment with systemic and inhaled steroids, β(2)-agonists, leukotrien-antagonists. Adaptive desactivation can induce a reversible tolerance to NSAID which also leads to an improvement in signs and symptoms of the underlying AERD.

A VSV-G Pseudotyped Last Generation Lentiviral Vector Mediates High Level and Persistent Gene Transfer in Models of Airway Epithelium In Vitro and In Vivo

The aim of this work was to evaluate the efficiency and duration of gene expression mediated by a VSV-G pseudotyped last generation lentiviral (LV) vector. We studied LV efficiency in ex-vivo models of respiratory epithelial cells, obtained from bronchial biopsies and nasal polyps, by GFP epifluorescence and cytofluorimetry. In vivo efficiency and persistence of gene expression was investigated by GFP immunohistochemistry and luciferase activity in lung cryosections and homogenates, respectively, upon intranasal and intratracheal administration protocols in C57Bl/6 mice. Both primary bronchial and nasal epithelial cells were transduced up to 70–80% 72 hr after the LV infection. In vivo nasal luciferase expression was increased by lysophosphatidylcholine pre-treatment of the nose. Conversely, the bronchial epithelium was transduced in the absence of any pre-conditioning treatment and luciferase expression lasted for at least 6 months without any decline. We conclude that a last generation LV vector is a promising gene transfer agent in the target organ of genetic and acquired lung diseases, as in the case of cystic fibrosis.

A Case of Bronchial Polyp Due to a Fishbone, Treated with Endobronchial Argon Plasma Laser Coagulation

A Case of Bronchial Polyp Due to a Fishbone, Treated with Endobronchial Argon Plasma Laser Coagulation

Clinical and functional featuresof respiratory heat exchange and cold airway hyperresponsiveness in patients with bronchial asthma and chronic polypous rhinosinusitis

The aim of the study was to investigate airway conditioning function and cold hyperresponsiveness in patients with bronchial asthma (BA) and nasal polyps. One hundred and eleven asthma patients with or without chronic polypous rhinosinusitis (CPR) were examined. Respiratory heat exchange and cold airway hyperresponsiveness were assessed using thermometry of expired air during quiet breathing and isocapnic hyperventilation with cold air in comparison with a group of healthy persons. The conditioning nasal function was worsened in BA patients with CPRS. Disorders of nasal heat exchange led to decreased temperature of the exhaled air during quiet breathing and cold hyperventilation. These disorders were closely related to increased frequency and severity of cold airway hyperresponsiveness.

Pleomorphic Adenoma with an Endobronchial Resection

A case of bronchial pleomorphic adenoma is herein presented. The patient came to the hospital for a detailed examination of a bronchial polyp that was detected by computed tomography. Chest computed tomography revealed a bronchial tumor which was located at the distal end of the left main bronchus. The patient refused surgical resection. An electrosurgical snare was performed two times and the patient received several rounds of argon plasma coagulation with a flexible bronchoscope. The diagnosis of a pleomorphic adenoma was made following examination of the resected specimens. No recurrence has been observed by biopsy at the resected site.

Bronchoscopic Image: Benign Bronchial Polyp

Benign endobronchial lesions are an uncommon finding on bronchoscopic examination. We present the case of a man with a pedunculated endobronchial lesion in an area of bronchiectasis that was found to be a benign bronchial polyp on surgical resection. We will present the case and review the literature on benign bronchial polyps.

Cytomegalovirus Infection Presenting as Bronchial Polyps in Lung Transplant Recipients

Cytomegalovirus (CMV) is the most important opportunistic pathogen in lung transplant recipients and is associated with direct and indirect morbidity. Infection or disease with CMV is often diagnosed through detection of the virus in the blood, culture of bronchoalveolar lavage fluid, or histologic examination of lung tissue obtained on transbronchial biopsy. Endobronchial lesions involving the virus have received little attention, however. We reviewed the records of 76 endobronchial biopsies obtained at our institution from January 1999 through October 2004 and performed a detailed examination of the specimens and clinical histories for all patients with biopsy evidence of bronchial CMV infection. We identified three patients with endobronchial CMV infection, manifested in each case as an endobronchial polyp. On histologic examination of the endobronchial biopsy specimens, cells with cytopathic effects characteristic or suggestive of CMV infection were present in two cases, and immunohistochemical staining confirmed the presence of CMV in all three. All patients were clinically well with normal chest X-rays before biopsy. Two of three patients had multiple subsequent episodes of CMV disease. To our knowledge, this is the first report of endobronchial polypoid CMV disease in lung transplant recipients. Our results suggest that biopsy of endobronchial lesions in pulmonary allografts should be pursued to establish a definitive etiology.