Tuberc Respir Dis.  2008 Oct;65(4):313-317.

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

• Son JY
• Jung JY
• Ha YJ
• Hong SJ
• Jung MK
• Chung MJ
• Seo YS
• Moon JA
• Byun MK
• Park BH
• Moon JW
• Park MS
• Kim YS
• Chang J
• Kim SK
• Chung KY
• Kim SK

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.

Keyword

Endobronchial lipoma; Bronchiolitis obliterans-organizing pneumonia

MeSH Terms

Bronchiolitis
Bronchiolitis Obliterans
Bronchoscopy
Collagen
Connective Tissue Diseases
Cryptogenic Organizing Pneumonia
Fibroblasts
Granulation Tissue
Humans
Lipoma
Lung
Lung Neoplasms
Male
Pneumonia
Smoke
Smoking
Collagen
Smoke

Figure

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  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.

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  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.

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  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.

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  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).

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  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).

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