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Open Access Case report

A solitary bronchial papilloma with unusual endoscopic presentation: case study and literature review

Fabrice Paganin1, Martine Prevot2, Jean Baptiste Noel3, Marie Frejeville2, Claude Arvin-Berod1 and Arnaud Bourdin14*

Author Affiliations

1 Service de Pneumologie. GHSR. St Pierre. France

2 Service d'Anatomo-Pathologie. GHSR. St Pierre. France

3 Service de Radiologie. GHSR. St Pierre. France

4 Service de Pneumologie. Hôpital Arnaud de Villeneuve. Montpellier. France

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BMC Pulmonary Medicine 2009, 9:40  doi:10.1186/1471-2466-9-40

Published: 18 August 2009

Abstract

Background

Solitary endobronchial papillomas (SEP) are rare tumors and most of them are described by case report. A misdiagnosis is common with viral related papillomas. A histopathological classification has recently permitted a major advancement in the understanding of the disease.

Case Presentation

We report a case of a mixed bronchial papilloma with an unusual endoscopic presentation. The literature was extensively reviewed to ascertain the unusual characteristics of the current case. A 39-year of age male was referred to our institution for the investigation of a slight hemoptysis. Routine examination was normal. A fibroscopy revealed an unusual feature of the right main bronchus. The lesion was a plane, non-bleeding, non-glistering sub-mucosal proliferation. No enhanced coloration was noticed. Biopsies revealed a mixed solitary bronchial papilloma. In situ HPV hybridization was negative. Endoscopic treatment (electrocautery) was effective with no relapse.

Conclusion

This lesion contrasts with the data of the literature where papilloma were described as wart-like lesions or cauliflower tumors, with symptoms generally related to bronchial obstruction. We advise chest physicians to be cautious with unusually small swollen lesions of the bronchi that may reveal a solitary bronchial papilloma. Endoscopic imaging can significantly contribute to the difficult diagnosis of SEP by pulmonary physicians and endoscopists.