Endobronchial lipoma: a rare cause of subsegmental bronchial obstruction.

Endobronchial lipoma is a rare cause of bronchial obstruction. Early identification and diagnosis of endobronchial lipoma can prevent damage of the lung parenchyma. Clinicians should be aware of this rare tumour. Bronchoscopic resection is the first choice of treatment, but surgical operation should be indicated in certain circumstances.

Clinical Image

A 72‐year‐old man nonsmoker presented with dyspnea, persistent cough with an episode of shortness of breath and high‐grade fever of 2 months duration. The patient had a medical history of bronchiectasis and frequent chest infections for the past 4 years. Physical examination revealed decreased respiratory sounds, diffuse wheezing, and fine crackles over of the left lower lobe. Computed tomography (CT) scan revealed an endoluminal homogeneous mass, 15 × 16 mm in size and CT value of −120HU, in the subsegment of the left posterior basal segment with no calcification seen. Postobstructive bronchus was enlarged of 21 mm with local atelectasis (Figs. 1, 2). Flexible bronchoscopy revealed an occluded a‐subsegment of the left posterior basal segment (LB10a) that was completely occupied with an endobronchial tumour (Fig. 3). The mass had a rounded, smooth, and shiny surface with an area of vascularity and lipoma was suspected, biopsy was performed simultaneously. Biopsy specimens showed groups of adipocytes and adipoblasts with no evidence of malignancy (Fig. 4). The patient underwent treatment with intravenous antibiotics for post‐obstructive pneumonia. Bronchoscopic resection was proposed during initial endoscopic procedure, but it was denied by the patient. In literature we have found only three case reports about subsegmental bronchial lipoma 1.

Figure 1

Computed tomography scan of thorax with axial reconstruction showed homogenous mass (arrow) with fat density in a subsegment of the left posterior basal segment (LB10).

Figure 2

Computed tomography scan of thorax with coronal reconstruction revealed an obstruction of a subsegment of the left posterior basal segment with postobstructive atelectasis (arrows).

Figure 3

Flexible bronchoscopy photographs before biopsy show the obstructive character of the lesion as yellowish polypoid mass. Bronchoscope in a‐subsegment of the left posterior basal segment (LB10a).

Figure 4

(A) Endobronchial biopsy specimens. A fragment of respiratory epithelium with acute inflammatory reactions and without cytonuclear atypia with fat tissue located centrally with H&E stain ×100. (B) Endobronchial biopsy specimens. Groups of adipocytes and adipoblasts (arrows) with H&E stain ×200.

Disclosure Statement

Appropriate written informed consent was obtained for publication of this case report and accompanying images.