Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
A Solitary Bronchial Papilloma with Malignant Changes
Yuichi INOUEMikio OKAHiroshi ISHIIKoji KIMINOMasao KISHIKAWAMasahiro ITOTetsuya ITOMasahiro NAKASHIMAShigeru KOHNO
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JOURNAL FREE ACCESS

2001 Volume 40 Issue 1 Pages 56-60

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Abstract

We describe a case of solitary papilloma of the bronchus and provide a review of 38 similar cases reported in Japan. A 70-year-old man complained of cough and sputum. Chest X-rays and CT scans revealed atelectasis of the right middle lobe. On bronchoscopy, a polypoid tumor was found at the orifice of the bronchus of the right middle lobe. The tumor was histologically diagnosed as a squamous papilloma with moderate atypia. Because of elevated tumor markers and the reported high incidence of malignant changes in papillomas, the tumor was endoscopically resected by electrosurgical snare. While this procedure resulted in improvement of atelectasis, the chest CT taken subsequently revealed a mass adjacent to the resected polypoid tumor in the middle lobe bronchus. Percutaneous needle biopsy followed by histopathological examination confirmed the tumor to be a squamous cell carcinoma. Only three cases of malignant changes in papillomas have been previously reported in Japan. Electrosurgical snare, which allows the identification of tissue at the tumor base, should be the treatment of choice rather than YAG laser surgery.
(Internal Medicine 40: 56-60, 2001)

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© The Japanese Society of Internal Medicine
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