Journal List > Tuberc Respir Dis > v.65(4) > 1001288

TOOLS
Son, Jung, Ha, Hong, Jung, Chung, Seo, Moon, Byun, Park, Moon, Park, Kim, Chang, Kim, Chung, and Kim: A Case of Endobronchial Lipoma Causing Right Middle and Lower Lobes Collapse and Bronchiolitis Obliterans-organizing Pneumonia
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(4): 313-317.

Published online: 31 October 2008

DOI: https://doi.org/10.4046/trd.2008.65.4.313

A Case of Endobronchial Lipoma Causing Right Middle and Lower Lobes Collapse and Bronchiolitis Obliterans-organizing Pneumonia

Ji Young Son, M.D.1, Ji Ye Jung, M.D.1, You Jung Ha, M.D.1, Soo Jung Hong, M.D.1, Min Kyu Jung, M.D.1, Moon Jae Chung, M.D.1, Yong Sung Seo, M.D.1, Ji Ae Moon, M.D.1, Min Kwang Byun, M.D.1, Byung Hoon Park, M.D.1, Jin Wook Moon, M.D.1, 2, Moo Suk Park, M.D.1, 2, Young Sam Kim, M.D.1, 2, Joon Chang, M.D.1, 2, Sang Kyum Kim, M.D.3, Kyung Young Chung, M.D.4, Se Kyu Kim, M.D.1, 2

1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

2The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.

3Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.

4Department of Cardiovascular and Thoracic Surgery, Yonsei University College of Medicine, Seoul, Korea.

Address for correspondence: Se Kyu Kim, M.D. Department of Internal Medicine, Yonsei University College of Medicine, 250, Seongsanno, Seodaemun-gu, Seoul 120-740, Korea. Phone: 82-2-2228-1954, Fax: 82-2-393-6884, sekyukim@yuhs.ac

Received 23 July 2008       Accepted 12 August 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Lipoma is a common neoplasm in soft tissues. However, an intrapulmonary lipoma is a rare benign tumor. Patients with a bronchial lipoma might have a malignant potential related to their smoking history due to the case reports of lung cancer accompanied with lipoma. Endobronchial lipoma can cause irreversible parenchymal lung damage if not diagnosed and treated early. Therefore, it should initially be treated by fiberoptic bronchoscopy or surgery depending on the status of distal parenchymal lung damage. Bronchiolitis obliterans with organizing pneumonia (BOOP) is a pathological syndrome that is defined by the presence of buds of granulation tissue consisting of fibroblasts and collagen within the lumen of the distal air spaces. BOOP is caused by drug intoxication, connective tissue disease, infection, obstructive pneumonia, tumors, or an unknown etiology. We encountered a 58 year-old male patient with endobronchial lipoma, causing the collapse of the right middle and lower lobes, and BOOP due to obstructive pneumonia.

Keywords: Endobronchial lipoma, Bronchiolitis obliterans-organizing pneumonia

Figures and Tables

Figure 1
Chest PA shows a hazy density in right lower lung field with obliteration of the costophrenic angle, suggesting lung collapse and pleural effusion.
trd-65-313-g001
Figure 2
(A) Chest CT scan shows an endobronchial mass (arrow) in the intermediate bronchus, and the portion of the mass contains fat attenuation, suggesting endobronchial hamartoma. (B) Obstructive pneumonia in right middle and lower lobes and small amount of right pleural effusion were observed.
trd-65-313-g002
Figure 3
Bronchoscopic finding of endobronchial lipoma. Intermedius bronchus was completely obstructed with a round mass, which has smooth, yellow colored surface. (A) Right second carina level. (B) Endobronchial mass.
trd-65-313-g003
Figure 4
Microscopic finding of endobronchial lipoma. Microscopic findings reveal mature fat tissue with overlying bland looking ciliated columnar bronchial epithelium (H&E stain, ×100).
trd-65-313-g004
Figure 5
Microscopic finding of Bronchiolitis obliteransorganizing pneumonia. Microscopic findings reveal plugging of small airways and alveoli with loose fibrotic material and surrounding interstitial inflammation (H&E stain, ×100).
trd-65-313-g005

References

1. Yokozaki M, Kodama T, Yokose T, Nishimura M, Yoshida J, Mizokami H, et al. Endobronchial lipoma: a report of three cases. Jpn J Clin Oncol. 1996. 26:53–57.
2. Nomori H, Horio H, Suemasu K. Two-stage operation for endobronchial lipoma and lung cancer using bronchoscopy and thoracoscopy in an elderly patient with chronic obstructive pulmonary disease. Jpn J Thorac Cardiovasc Surg. 1999. 47:567–569.
3. Rokitansky C. A manual of pathological anatomy. 1854. London: Sydenham Society;196.
4. Kim HJ, Wang JH, In HH, Song KH, Song JO, Song KS, et al. A case of endobronchial lipoma causing middle lobe syndrome. Tuberc Respir Dis. 1997. 44:191–196.
5. Lee JM, Park JH, Baik HJ, Zo JI. A case report of endobronchial lipoma. Korean J Thorac Cardiovasc Surg. 1997. 30:116–118.
6. Chung SS, Kim HJ, Byun KH, Park HS, Song JW, Cho JS, et al. A case of endobronchial lipoma causing left lung collapse. Korean J Med. 1998. 55:415–419.
7. Jeong NY, Yang DG, Kim SK. Endobronchial lipoma. Diagn Treat. 2001. 21:1325–1327.
8. Park CB, Cho DG, Ahn MI, Song SH, Kim CH, Yoo JY, et al. Endobronchial lipoma diagnosed by chest CT: a case report. Korean J Thorac Cardiovasc Surg. 2003. 36:39–42.
9. Kim JW, Huh JG, Lee HK, Joo M, Kim SW, Ku BI, et al. Endobronchial lipomatous hamartoma removed by bronchotomy: one case report. Korean J Thorac Cardiovasc Surg. 2003. 36:870–873.
10. Schlesinger C, Koss MN. The organizing pneumonias: an update and review. Curr Opin Pulm Med. 2005. 11:422–430.
11. Cockcroft DW, Copland GM, Donevan RE, Gourlay RH. Endobronchial lipoma: two cases and review of the literature. Can Med Assoc J. 1976. 115:326–328.
12. Box K, Kerr KM, Jeffrey RR, Douglas JG. Endobronchial lipoma associated with lobar bronchiectasis. Respir Med. 1991. 85:71–72.
13. Schraufnagel DE, Morin JE, Wang NS. Endobronchial lipoma. Chest. 1979. 75:97–99.
14. Politis J, Funahashi A, Gehlsen JA, DeCock D, Stengel BF, Choi H. Intrathoracic lipomas: report of three cases and review of the literature with emphasis on endobronchial lipoma. J Thorac Cardiovasc Surg. 1979. 77:550–556.
15. Suzuki N, Takizawa H, Yamaguchi M, Matsuzaki G, Kiyosawa H, Dohi M, et al. A case of asymptomatic endobronchial lipoma followed for 4 years. Nihon Kyobu Shikkan Gakkai Zasshi. 1992. 30:1879–1883.
16. Tomashefski JF Jr. Benign endobronchial mesenchymal tumors: their relationship to parenchymal pulmonary hamartomas. Am J Surg Pathol. 1982. 6:531–540.
17. Stey CA, Vogt P, Russi EW. Endobronchial lipomatous hamartoma: a rare cause of bronchial occlusion. Chest. 1998. 113:254–255.
18. Muraoka M, Oka T, Akamine S, Nagayasu T, Iseki M, Suyama N, et al. Endobronchial lipoma: review of 64 cases reported in Japan. Chest. 2003. 123:293–296.
19. Mata JM, Caceres J, Ferrer J, Gomez E, Castaner F, Velayos A. Endobronchial lipoma: CT diagnosis. J Comput Assist Tomogr. 1991. 15:750–751.
20. Simmers TA, Jie C, Sie B. Endobronchial lipoma posing as carcinoma. Neth J Med. 1997. 51:143–145.
TOOLS
Similar articles