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Case Reports
. 2020 Apr 7:30:101053.
doi: 10.1016/j.rmcr.2020.101053. eCollection 2020.

Bronchial HPV; the good the bad and the unknown

Paul Zarogoulidis  1 , Stavros Tryfon  2 , Konstantinos Sapalidis  1 , Kosmas Tsakiridis  3 , Sofia Baka  4 , Haidong Huang  5 , Chong Bai  5 , Wolfgang Hohenforst-Schmidt  6 , Dimitris Hatzibougias  7 , Evaggelia Athanasiou  7 , Anastasios Vagionas  8 , Maria Saroglou  2 , Christoforos Kosmidis  1
Affiliations
Case Reports

Bronchial HPV; the good the bad and the unknown

Paul Zarogoulidis et al. Respir Med Case Rep. .

Abstract

Background: Solitary tracheobronchial papilloma (STBP) is a rare benign tumor. Human papilloma virus (HPV) infection is associated with dysplasia and a high risk of carcinoma.

Case 1: Sixty five year old male with hemoptysis and with coilocytic atypia, indicating the presence of HPV.

Case 2: Thirty two year old female with a polypoid villoglandular bronchial structure and no cytoplasmic or nuclear atypia but prominent microvilli.

Discussion: Tissue sample is the best sample in order to determine and distinguish the two entities, local treatment should be considered as first option when possible.

Keywords: Argon plasma; Bronchoscopy; Cruotherapy; EBUS; Jet-ventilation; Surgery; YAG-Laser; hpv.

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Conflict of interest statement

None to declare.

Figures

Fig. 1
Fig. 1
Left blue arrows indicate the lesions and right the convex probe endobronchial ultrasound indicates the depth of the lesions and surrounding vessels. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
Fig. 2
Fig. 2
Hematoxylin/Eosin x 40, Among the bronchial mucus producing epithelium, revealed a exophytic polyloid structure of multilayerd squamous epithelium.
Fig. 3
Fig. 3
Hematoxylin/Eosin x 200, The polypoid structure exhibit hyperplastic basal layer composed of small cells with dark nucleus with minimal atypia and small number of mitosis. The parabasal layer was also hyperplastic and the inner layer was paraceratotic.
Fig. 4
Fig. 4
Hematoxylin/Eosin x 400, In the acanthotic layer there were numerous cells with small, sringed nucleus sorrounden by perinuclear halo and evidence of coilocytic atypia.
Fig. 5
Fig. 5
Immunostain for p16 antibody developed nuclear and cytoplasmic positivity in cells with coilocytic atypia, indicating the presence of HPV.
Fig. 6
Fig. 6
Left lesion in the trachea, right lesion in the left main stem bronchus.
Fig. 7
Fig. 7
Hematoxylin/Eosin x 200, This is a polypoid villoglandular bronchial structure, composed of long columnar respiratory type cells. There is no cytoplasmic or nuclear atypia but prominent microvilli.
Fig. 8
Fig. 8
Hematoxylin/Eosin x 400, The fibrovascular cores were delicate and thin, composed of numerous mucin producting cells reminisced “Goblet cells”.
Fig. 9
Fig. 9
From left to right; STORZ rigid bronchoscope with 12mm outer rim and 11mm inner rim, argon plasma coagulation system (APC), cryotherapy system, YAG-laser system.
Fig. 10
Fig. 10
Patient under general anesthesia, semi rigid technique with the endobronchial ultrasound bronchospe EBUS convex probe inserted through the rigid bronchoscope and Jet-Ventilation model.
See this image and copyright information in PMC

References

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