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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Benign neoplasms of the tracheobronchial tree are rare&#46; Endobronchial lipoma is a benign tumour with an incidence of 0&#46;1&#37;&#8211;0&#46;5&#37; of all lung neoplasms&#46; It originates from the cells of the peribronchial adipose tissue and&#44; occasionally&#44; from the sub-mucosal tissue of the main bronchus&#46; Clinical symptoms depend on its location&#44; degree of bronchial obstruction and morphological and functional consequences of the obstruction on the distal parenchyma&#46; Thus&#44; early diagnosis and radical treatment are essential in order to avoid irreversible pulmonary lesions&#46; We present the case of a 63-year-old man with endobronchial lipoma&#44; who underwent anatomical lung resection due to his late diagnosis&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinical Case</span><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was a 63-year-old man&#44; ex-smoker for 36 years &#40;40 pack-years&#41;&#44; with a history of bronchial asthma&#46; He had symptoms of a dry cough and intermittent dyspnoea&#44; and was being monitored in the Respiratory Medicine department for bronchiectasis&#46; A routine computed tomography &#40;CT&#41; scan for his respiratory disease highlighted the presence of an endobronchial lesion in the left lower lobe &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; Fibrobronchoscopy was subsequently performed&#44; showing an endoluminal lesion in the lower bronchus&#46; No malignant neoplastic signs were detected in either the biopsy or cytology&#44; despite repeating these studies on a further two occasions&#46; In view of these findings and the absence of symptoms&#44; it was decided to maintain clinical and radiological follow-up&#46; In the last few months&#44; he had episodes of haemoptysis and persistent respiratory infections that improved with antibiotic treatment&#46; New imaging tests &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41; and an endoscopic examination &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41; revealed an increase in the size of the polypoid lesion extending towards the left main bronchus&#44; more than 2<span class="elsevierStyleHsp" style=""></span>cm from the main carina&#46; Acute inflammatory changes were also observed on this occasion&#44; both in the bronchial aspirate and in the bronchial biopsy&#44; with no neoplastic cells detected&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Due to the suspicion of a malignant lesion and the difficulty in obtaining a diagnosis&#44; it was decided to operate on the patient&#46; A video thorascopic examination was performed&#44; observing the presence of signs of hepatisation and fibrosis in the lower lobe&#44; as well as the presence of multiple firm adhesions mainly in the costodiaphragmatic recess&#44; which prevented the examination from being completed&#46; A left lower lobectomy was eventually performed by lateral thoracotomy&#46; When the lower bronchus was sectioned&#44; a 2<span class="elsevierStyleHsp" style=""></span>cm yellow pediculated tumour with smooth borders was identified&#44; originating from the walls of the lower lobe bronchus and protruding towards the lumen of the main bronchus &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>D&#41;&#46; The patient did not present any complications during the post-operative period and was discharged on the fifth day&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The pathology study revealed the lesion to be a benign mesenchymal neoplasm made up of mature adipose tissue surrounding bronchial glandular structures&#46; In view of these findings&#44; a diagnosis of endobronchial lipoma was made&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">Endobronchial lipomas are extremely rare benign lung tumours that represent 0&#46;1&#37;&#8211;0&#46;5&#37; of all lung neoplasms&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> They are more common in men&#44; with a peak incidence between the fifth and sixth decades of life&#46; Obesity and smoking are considered risk factors&#44; although there are no conclusive studies&#46; Endothoracic lipomas can be classified into 5 groups&#58; cardiac&#44; parenchymatous&#44; pleural&#44; mediastinal and endobronchial&#44; as in our case&#46; In most cases described in the literature&#44; the tumour is located in the first three subdivisions of the tracheobronchial tree&#44; and is more common on the right side&#44; although in our case&#44; it originated in the left lower lobe bronchus&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Cough&#44; progressive dyspnoea&#44; haemoptysis and recurrent pneumonia are the most common forms of presentation&#46; These patients can sometimes be erroneously diagnosed with bronchial asthma&#44; delaying the diagnosis of these types of lesions&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> Fibrobronchoscopy is the fundamental tool for its diagnosis&#44; enabling the lesion to be located and biopsied&#44;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> although in our case the samples obtained were unrepresentative &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Despite their benign nature&#44; their growth can cause partial or total obstruction of the bronchus&#44; as well as destruction of the distal parenchyma&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Bronchoscopic resection should be considered as the first therapeutic option&#44; as it avoids both thoracotomy and lung resection&#44; with the resulting functional impact that this entails&#46; However&#44; if there are irreversible changes in the parenchyma&#44; such as fibrosis&#44; pneumonia or atelectasis&#44; lung resection must be performed&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4&#44;5</span></a> In our case&#44; the presence of said findings&#44; due to the late diagnosis&#44; did not allow endoscopic resection to be carried out&#44; and a lower lobectomy was necessary&#46;</p></span></span>"
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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Endobronchial lipoma is a rare benign neoplasm of the tracheobronchial tree&#46; Despite its benign nature&#44; associated endoluminal polypoid growth can cause bronchial occlusion&#46; In this paper&#44; we present the consequences of a late diagnosis of this condition&#46;</p>"
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        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El lipoma endobronquial es una neoplasia benigna del &#225;rbol traqueobronquial poco frecuente&#46; A pesar de su naturaleza benigna&#44; puede producir la oclusi&#243;n bronquial&#44; debido a su crecimiento polipoide endoluminal&#46; En este art&#237;culo se presentan las consecuencias de un diagn&#243;stico tard&#237;o en este tipo de lesiones&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Trivi&#241;o A&#44; Mora-Cabezas M&#44; Vallejo-Benitez A&#44; Garc&#237;a-Escudero A&#44; Gonz&#225;lez-C&#225;mpora R&#46; Lipoma endobronquial&#58; una causa poco frecuente de obstrucci&#243;n bronquial&#46; Arch Bronconeumol&#46; 2013&#59;49&#58;494&#8211;496&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; An endobronchial lesion can be observed in the left lower lobe at the level of the interlobar carina on the chest CT scan&#46; &#40;B&#41; Chest CT scan one year later&#58; growth of the endobronchial lesion towards the lumen of the main bronchus can be seen&#46; &#40;C&#41; Fibrobronchoscopy&#58; endobronchial lesion protruding towards and partially occluding the lumen of the main bronchus&#46; &#40;D&#41; Surgical specimen&#58; polypoid lesion originating from the lower lobe bronchus&#46;</p>"
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