Tuberc Respir Dis.  2013 Feb;74(2):82-85.

Successful Removal of Endobronchial Lipoma by Flexible Bronchoscopy Using Electrosurgical Snare

• Yun SC
• Na MJ
• Choi E
• Kwon SJ
• Lee SJ
• Oh SH
• Cha EJ
• Son JW

Abstract

A 62-year-old man with a chronic cough presented with atelectasis of the left upper lobe on chest X-ray. Chest computed tomography showed an atelectasis in the left upper lobe with bronchial wall thickening, stenosis, dilatation, and mucoid impaction. We performed bronchoscopy and found a well-circumscribed mass on the left upper lobe bronchus. The mass was removed by flexible bronchoscopy using an electrosurgical snare and diagnosed with lipoma. An endobronchial lipoma is a rare benign tumor that can be treated by a surgical or endoscopic approach. We report the successful removal of endobronchial lipoma via flexible bronchoscopic electrosurgical snare.

Keyword

Bronchoscopy; Electrocoagulation; Lipoma

MeSH Terms

Bronchi
Bronchoscopy
Constriction, Pathologic
Cough
Dilatation
Electrocoagulation
Lipoma
Pulmonary Atelectasis
SNARE Proteins
Thorax
SNARE Proteins

Figure

• 

  Figure 1 Chest X-ray and chest computed tomography (CT) image. (A) At admission, chest X-ray revealed atelectasis. (B) After 1.5 months, chest X-ray showed improvement of atelectasis. (C) At admission, chest CT revealed mucoid impaction in left upper lobe bronchus. (D) After 1.5 months, chest CT showed no definite mass lesion in the left upper lobe bronchus.

• 

  Figure 2 Datails of the procedure. (A) Endoscopic electrosurgical snare. (B) Bronchoscopic finding of endobronchial lipoma. The left upper lobe bronchus was obstructed with a round mass, which has a smooth, yellow colored surface. (C) Just after the mass was removed by electrosurgical snare, the left upper lobe bronchus was reopened. The tumor base was remained. (D) The resected endobronchial tumor.

• 

  Figure 3 Details of follow-up. (A) On follow-up bronchoscopy, there was a remaining mass on the left upper lobe B2. (B) After removal of the remaining mass by forceps, the left upper lobe bronchus was successfully reopened.

Reference

1. Muraoka M, Oka T, Akamine S, Nagayasu T, Iseki M, Suyama N, et al. Endobronchial lipoma: review of 64 cases reported in Japan. Chest. 2003. 123:293–296.

2. Nassiri AH, Dutau H, Breen D, Colchen A, Quiot JJ, Nguyen B, et al. A multicenter retrospective study investigating the role of interventional bronchoscopic techniques in the management of endobronchial lipomas. Respiration. 2008. 75:79–84.

3. Iwabuchi H, Kamura T, Tanaka M, Kato H. A case of endobronchial lipoma. Diagn Ther Endosc. 1999. 5:263–267.

4. Cao D, Sun Y, Yang S. Endobronchial lipoma: an unusual cause of bronchial obstruction. Case Rep Med. 2011. 2011:939808.

5. Ouadnouni Y, Bouchikh M, Bekarsabein S, Achir A, Smahi M, Msougar Y, et al. Endobronchial lipoma a rare cause of pleural empyema: a case report. Cases J. 2009. 2:6377.

6. Choi JC, Yu CM, Ryu YJ, Jeon K, Choi KA, Kwon OJ, et al. The role of endoscopic surgery for completely obstructive endobronchial benign tumor. Korean J Intern Med. 2006. 21:15–19.

7. Hurt R. Benign tumours of the bronchus and trachea, 1951-1981. Ann R Coll Surg Engl. 1984. 66:22–26.

8. MacArthur CG, Cheung DL, Spiro SG. Endobronchial lipoma: a review with four cases. Br J Dis Chest. 1977. 71:93–100.

9. Lamprecht B, Hutarew G, Porsch P, Wegleitner B, Studnicka M. Successful bronchoscopic cryorecanalization in a case of endobronchial lipoma. Diagn Ther Endosc. 2011. 2011:845686.

10. Landa JF. Indications for bronchoscopy. Chest. 1978. 73:5 Suppl. 686–690.

11. Boxem T, Muller M, Venmans B, Postmus P, Sutedja T. Nd-YAG laser vs bronchoscopic electrocautery for palliation of symptomatic airway obstruction: a cost-effectiveness study. Chest. 1999. 116:1108–1112.

12. van Boxem AJ, Westerga J, Venmans BJ, Postmus PE, Sutedja G. Photodynamic therapy, Nd-YAG laser and electrocautery for treating early-stage intraluminal cancer: which to choose? Lung Cancer. 2001. 31:31–36.

13. Bolliger CT, Sutedja TG, Strausz J, Freitag L. Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents. Eur Respir J. 2006. 27:1258–1271.

14. Choi SH, Kang JY, Joo YB, Kim SK, Mo EY, Lee SH, et al. An endobronchial lipoma treated by bronchoscopic excision. Korean J Med. 2011. 80:337–342.