Letter to the Editor
Talking About Endobronchial Lipoma
A propósito del lipoma endobronquial
Juan José Guelbenzu Zazpe
, Elena Ramírez Gil, Ester Vilá Mayo
Corresponding author
Servicio de Cirugía Torácica, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
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Increased density with upper right paratracheal rounded mass was observed on chest X-ray; chest computed tomography showed partial atelectasis of the right upper lobe (RUL); bronchoscopy showed a soft, rounded, pinkish, vascularized lesion in the entrance to the RUL; biopsy revealed metaplastic bronchial mucosa; and pathological contrast uptake was seen on positron emission tomography (PET). With a diagnosis of a RUL lesion with uptake on PET, a thoracotomy with upper right lobectomy and lymphadenectomy was performed. Pathology report revealed endobronchial lipoma with focal osseous metaplasia, alveolar hemorrhage, areas of bronchopneumonia and obstructive architectural distortion.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Discussion</span><p id="par0010" class="elsevierStylePara elsevierViewall">Endobronchial lipoma is a very rare tumor, accounting for only 0.1% of all lung tumors.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> They are usually located in the first 3 divisions of the tracheobronchial tree. The most common symptoms are cough, expectoration, hemoptysis, fever and dyspnea, although 25% of cases may be asymptomatic.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> The lipoma consists of mature fatty tissue covered with normal bronchial epithelium or–as in our case–squamous metaplasia.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> Fibrous, glandular tissue, areas of cartilage or osseous metaplasia can also be found in the lipoma; pathologist must use differential diagnosis to rule out atypical lipomatous tumors and well-differentiated liposarcomas.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> Treatment of choice is bronchoscopic resection, while thoracotomy should be considered in difficult-to-diagnose cases, when there is parenchymal destruction due to atelectasis and long-standing pneumonitis, extrabronchial growth, or if bronchoscopy cannot be used for technical reasons.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> Nevertheless, in view of the possibility of long-term relapse, we recommend regular follow-up of patients undergoing bronchoscopic resection.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Discussion" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Guelbenzu Zazpe JJ, Ramírez Gil E, Vilá Mayo E. A propósito del lipoma endobronquial. Arch Bronconeumol. 2015;51:252–252.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lipoma endobronquial: una causa infrecuente de obstrucción bronquial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B. Lirios Sacristán" 1 => "E. Fernández Robledo" 2 => "F. Peña Blas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2013.06.008" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2014" "volumen" => "50" "paginaInicial" => "78" "paginaFinal" => "79" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24119688" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lipoma endobronquial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Marcote Valdivieso" 1 => "A. Baltasar Torrejón" 2 => "R. Bou Pérez" 3 => "J. Vierna García" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cir Esp" "fecha" => "1990" "volumen" => "4" "paginaInicial" => "460" "paginaFinal" => "464" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endobronchial lipoma: a series of three cases and the role of electrocautery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Huisman" 1 => "K.W. Van Kralingen" 2 => "P.E. Postmus" 3 => "T.G. Sutedja" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "56302" "Revista" => array:6 [ "tituloSerie" => "Respiration" "fecha" => "2000" "volumen" => "67" "paginaInicial" => "689" "paginaFinal" => "692" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11124655" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endobronchial lipomatous tumors: clinicopathologic analysis of 12 cases with molecular cytogenetic evidence supporting classification as “lipoma”" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.M. Boland" 1 => "K.J. Fritchie" 2 => "M.R. Erickson-Johnson" 3 => "A.M. Oliveira" 4 => "T.V. Colby" 5 => "Folpe .F A.L." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PAS.0b013e3182a115c9" "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2013" "volumen" => "37" "paginaInicial" => "1715" "paginaFinal" => "1721" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24121172" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lipoma endobronquial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Leon" 1 => "G. Estrada" 2 => "S. Alvarez" 3 => "C. Pozo" 4 => "R. Bordes" 5 => "R. Corundella" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "1983" "volumen" => "19" "paginaInicial" => "217" "paginaFinal" => "219" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endobronchial lipoma. Review of 64 cases reported in Japan" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Muraoka" 1 => "T. Oka" 2 => "S. Akamine" 3 => "T. Nagayasu" 4 => "M. Iseki" 5 => "N. Suyama" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2003" "volumen" => "123" "paginaInicial" => "293" "paginaFinal" => "296" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12527636" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005100000005/v2_201504270531/S1579212915000403/v2_201504270531/en/main.assets" "Apartado" => array:4 [ "identificador" => "14576" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005100000005/v2_201504270531/S1579212915000403/v2_201504270531/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915000403?idApp=UINPBA00003Z" ]
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