Tracheobronchial rhinosporidiosis: an uncommon life-threatening benign cause of airway obstruction

Abstract

Rhinosporidiosis is a chronic granulomatous infectious disease caused by Mesomycetozoea Rhinosporidium seeberi. This highly recurrent polypoid lesion has a predilection for the nose and nasopharynx, although other organ systems may be affected. Involvement of the tracheobronchial tree is very rare, and poses a challenge for diagnosis and management. In this report, we present a 30-year-old man with a history of recurrent nasal polyp who presented with cough, shortness of breath, haemoptysis, and a radiological feature of right lung collapse on imaging. He was diagnosed with rhinosporidiosis based on histopathological examination of bronchoscopic biopsy specimen taken from the right principal bronchial mass. Shortly after hospitalization, he developed acute respiratory distress requiring emergency bronchoscopic intervention. A pinkish mulberry-like tracheal and right bronchial mass was removed endoscopically with cauterization of the base of the lesion. On long-term follow-up, the patient was free of symptoms without recurrence of airway disease.

Keywords: Bronchoscopy; bronchus; cauterization; rhinosporidiosis; trachea.

Figure 1

Chest X‐ray P/A view showing the right upper lobe collapse (A), and a polypoid mass at the level of carina on computed tomography scan of the chest (B).

Figure 2

Partially resected rhinosporidial mass.

Figure 3

Fibreoptic bronchoscopy one week later showing rhinosporidial mass hanging from the posterior pharyngeal wall (A), and a residual lesion in the right principal bronchus (B). Follow‐up bronchoscopy one and a half months later showing normal tracheobronchial lumen (C).

Figure 4

Follow‐up bronchoscopy: one and a half months later—regression of pharyngeal lesion (A), and two years later—recurrence of pharyngeal lesion (B).