Abstract
We report the case of a solitary bronchial papilloma with middle lobe syndrome that was speculated to be a hilar malignant tumor on 18F-deoxyglucose positron emission tomography (FDG-PET). A 66-year-old woman was referred to our hospital complaining of a continuous productive cough. Computed-tomography of the chest showed a right hilar mass and consecutive bronchial tumor with heterogeneous enhancement. The bronchial tumor and hilar mass were FDG-PET-positive, with a maximum standard uptake value of 10.6, suggesting a malignant neoplasm. Bronchofiberscopic tumor biopsy was repeated twice, but only suggested atypical squamous epithelium. An open biopsy of the bronchial tumor through a right thoracotomy was conducted, and intra-operative frozen sectioning of the bronchial tumor led to a diagnosis of papilloma. Then, a right middle sleeve-lobectomy was performed. The right hilar mass turned out to be mucopurulent secretions filling, obstructing, and dilating the right middle bronchus. The pathological diagnosis was mixed squamous cell and glandular papilloma. The patient is doing well without any signs of recurrence one year after the operation. It is important to note that bronchial tumors with obstructive pneumonia can present hilar cancer-like findings on FDG-PET.
