Eleonora Casalini1, Alberto Cavazza2, Alessandro Andreani3, Alessandro Marchioni1, Gloria Montanari1, Francesca Gaia Cappiello3, Maria Cecilia Mengoli4, Paolo Corradini1, Lorenzo Agostini5, Roberto Serini6, Giulio Rossi4. 1. Department of Oncology and Haematology, Respiratory Diseases Clinic, University Hospital Policlinico of Modena, Modena, Italy. 2. Department of Oncology and Advanced Technologies, Operative Unit of Pathologic Anatomy, Azienda Arcispedale S. Maria Nuova/IRCCS, Reggio Emilia, Italy. 3. Operative Unit of Pulmonology, Civic Hospital, Mirandola, Italy. 4. Department of Diagnostic Laboratories, Section of Pathologic Anatomy, University Hospital Policlinico of Modena, Modena, Italy. 5. Operative Unit of Pulmonology, Azienda Arcispedale S. Maria Nuova/IRCCS, Reggio Emilia, Italy. 6. Operative Unit of Pulmonology, Civic Hospital, Sassuolo, Italy.
Abstract
BACKGROUND AND AIMS: Bronchial fibroepithelial polyp is an uncommon, poorly recognised lesion, lacking clear diagnostic criteria at histology, but possibly mimicking neoplastic growth on clinico-radiologic and histopathological grounds. The aim of this study was to define the clinico-pathological features, bronchoscopic appearance and treatment of bronchial fibroepithelial polyp. METHODS: We collected the largest series of bronchial fibroepithelial polyps (15 consecutive cases), including clinico-pathological, bronchoscopic, radiologic and histological features. RESULTS: Overall, there were 13 males and 2 females, with a mean age of 68 years at diagnosis. Eight patients were asymptomatic, whereas four presented with haemoptysis, two with fever, cough and pneumonia-like opacity, and one with dry recurrent cough. Mean size of the lesion was 6.5 mm (range, 2-20 mm) without any prevalence for segmental bronchi. Lesions larger than 10 mm were always symptomatic and visible at computed tomography scans. At bronchoscopy, the lesion appeared as a firm endobronchial nodule with hard consistency and glistening, whitish, smooth surface. A multilobulated and sepimentated surface was observed in the largest polyps. Whatever the size, histological features were quite similar in all cases, consisting in a polypoid lesion with a dense, collagenous, hypocellular stroma with some thin-walled, ectatic vessels and a regular respiratory mucosa on surface. In-situ hybridisation with human papillomavirus probe was negative in all the eight tested cases. CONCLUSION: Despite the benign behaviour of bronchial fibroepithelial polyps, it is important to fix some robust diagnostic criteria in order to avoid misdiagnoses leading to unnecessary aggressive treatment. Differential diagnosis mainly includes inflammatory polyps, hamartomas and papillomas.
BACKGROUND AND AIMS: Bronchial fibroepithelial polyp is an uncommon, poorly recognised lesion, lacking clear diagnostic criteria at histology, but possibly mimicking neoplastic growth on clinico-radiologic and histopathological grounds. The aim of this study was to define the clinico-pathological features, bronchoscopic appearance and treatment of bronchial fibroepithelial polyp. METHODS: We collected the largest series of bronchial fibroepithelial polyps (15 consecutive cases), including clinico-pathological, bronchoscopic, radiologic and histological features. RESULTS: Overall, there were 13 males and 2 females, with a mean age of 68 years at diagnosis. Eight patients were asymptomatic, whereas four presented with haemoptysis, two with fever, cough and pneumonia-like opacity, and one with dry recurrent cough. Mean size of the lesion was 6.5 mm (range, 2-20 mm) without any prevalence for segmental bronchi. Lesions larger than 10 mm were always symptomatic and visible at computed tomography scans. At bronchoscopy, the lesion appeared as a firm endobronchial nodule with hard consistency and glistening, whitish, smooth surface. A multilobulated and sepimentated surface was observed in the largest polyps. Whatever the size, histological features were quite similar in all cases, consisting in a polypoid lesion with a dense, collagenous, hypocellular stroma with some thin-walled, ectatic vessels and a regular respiratory mucosa on surface. In-situ hybridisation with human papillomavirus probe was negative in all the eight tested cases. CONCLUSION: Despite the benign behaviour of bronchial fibroepithelial polyps, it is important to fix some robust diagnostic criteria in order to avoid misdiagnoses leading to unnecessary aggressive treatment. Differential diagnosis mainly includes inflammatory polyps, hamartomas and papillomas.
Authors: Gonzalo Labarca; Ivan Caviedes; Macarena R Vial; Yumay Pires; Erik Folch; Adnan Majid; Sebastian Fernandez-Bussy Journal: Respir Med Case Rep Date: 2017-08-09