Incidental synchronous bronchial tumour: an unusual bronchoscopic finding.

We describe a patient with incidental endobronchial synchronous hamartoma and typical carcinoid with different management strategy.

Clinical Image

A 49‐year‐old woman was admitted to our hospital due to paroxysmal dry cough and mild dyspnoea. She was treated with inhaled steroid and bronchodilator for asthma. On contrast‐enhanced chest computed tomography (CT) scan, a solid endobronchial lesion totally occluding the right upper bronchus and an incidental triangular‐shaped lesion on intermedius bronchus were shown (Fig. 1). Fibrobronchoscopy demonstrated a round‐shaped vascularized lesion with typical carcinoid findings located at the orifice of the right upper lobe bronchus and a soft polypoid lesion originating from the medial wall of the bronchus intermedius (Fig. 2A, B). Histological examinations revealed typical carcinoid and hamartoma. A different management strategy was performed [1]. Rigid bronchoscopy treatment with yttrium aluminium garnet (YAG) laser and right upper lobectomy allowed complete removal of the hamartoma and typical carcinoid [1, 2](Fig. 3).

Figure 1

Contrast‐enhanced chest computed tomography (CT) showed a vascularized round lesion with sub‐occlusion of the upper right bronchus (A) and a triangular lesion on intermedius bronchus (B).

Figure 2

Bronchoscopy view revealed a round‐shaped vascularized lesion sub‐obstructing the right upper lobe bronchus (A) and soft polypoid lesion originating from the distal bronchus intermedius (B). Bronchial scarring post laser‐assisted mechanical resection (C) and closure of bronchial stump following upper right lobectomy (D).

Figure 3

Moderately cellular cartilage fragments without atypia. (A) The polygonal tumour cells arranged in organoid and trabecular growth pattern (haematoxylin–eosin (H–E) stain, 2 mm). (B) Abundant eosinophilic cytoplasm with round‐oval nuclei and inconspicuous nucleoli were observed (H–E stain, 10×).

Disclosure Statement

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