気管支内脂肪腫の1例

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  • Endobronchial lipoma; a case report

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Endobronchial lipoma was diagnosed in a 58 year-old man. He had had a dry coughs for about eight months. A chest X-ray film and CT scan showed obstructive pneumonitis and atelectasis of the right S9 and S10 Bronchofiberscopy revealed a smooth yellowish tumor arising in the right B9+10, which filled the lumen of the bronchus. A biopsy specimen was not diagnostic. Right lower lobectomy was performed. The pathological examination disclosed an endobronchial lipoma, 10 × 6 mm in size, developing in the orifice of the right B9+10 accompanied by peripheral organizing pneumonia. Histologically, diffusely proliferating mature lipocytes involved the bronchial glands and peripheral nerves in the submucosa. These findings correspond more to those of localized lipomatosis than to those of ordinary lipoma. This is the 28th case of endobronchial lipoma to be reported in Japan. There have been 79 clinical cases of endobronchial lipoma in the English literature. The surgical treatment is bronchotomy or brochoplasty, such as sleeve resection, but segmentectomy or lobectomy may be necessary if peripheral lung tissue is destroyed following longstanding bronchial obstruction. The importance of early diagnosis of endobronchial lipoma is discussed.

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