Endobronchial lipoma

Abstract

Endobronchial lipomas are rare benign lung tumors that can cause bronchial obstruction and parenchymal damage. While an uncommon etiology, they are often misdiagnosed due to a clinical presentation similar to obstructive pulmonary pathologies such as COPD and asthma. Upon review of English-language literature, under 50 cases of endobronchial lipomas were documented in the prior 10 years (2011-2021). There are no clear guidelines regarding the management of this particular entity, but typically interventional debulking is the treatment of choice. Here we present another unique case of endobronchial lipoma along with our diagnostic and therapeutic methodology. The patient underwent bronchoscopic debulking via a cryotherapy probe. Based on the histopathologic analysis, a diagnosis of endobronchial lipoma was made. Endobronchial lipomas must remain in any clinician's differential when a patient presents with dyspnea. We report the unique location of this lipoma based on our literature review and the importance of investigating endobronchial lesions due to a possible diagnosis of endobronchial lipoma.

Keywords: Airway Obstruction; Bronchoscopy; Lipoma.

Figure 1. CT scan of the chest with IV contrast (A) Axial image shows a proximal right middle lobe bronchus hypodense lesion (arrow). (B) The lesion displays negative Hounsfield units (-90 HU) consistent with fat component.

Figure 2. Pathology Report (A): H&E, 10X; Ciliated bronchial epithelium (arrow) with endobronchial glands and interspersed adipocytes. (B): H&E, 20X; Mature adipocytes, endobronchial glands and endobronchial vessels (arrow).