ackground : Papillary tumors commonly arise in the upper respiratory tract but are exceedingly rare in the lower respiratory tract, especially in the bronchi. The tumors are derived from the bronchial surface epithelium and bronchial mucous
glands,
and
usually grow exohytically. Solitary papillomas of the bronchiare mostly well-differentiated, benign squamous epithelial tumors, and belong to the same class of tumors as pedunculated papillomas of the skin and mucous membranes. But in clinical
practice,
it is the most important that they can be malignantly transformed in patients with a history of previous radiation to relieve the symptoms or in individuals over 40 with recurrent solitary papillomas.
Methods : We experienced two cases of solitary bronchial papillomas which had occurred at
the level of main bronchus, and segmental bronchus, respectively.
Results : Patients were all over 50 years-old and had a history of cigarette-smoking.
Diagnoses were made from the biopsy specimens of the bronchoscopic examinations. A
peduncle was observed grossly in one case, while the other had the broad base.
Microscopically, they were covered typically with startified squamous epithelium in all cases
even though there were a little difference in their differentiation. In the second case,
malignant change was strongly suggested microscopically with invasion to the surrounding
organs on CT scan but brcause of the scanty biopsy tissue, we could not confirm whether it
was truly malignant or not. In one case, Nd-YAG Laser therapy was successfully performed
to relieve the obstruction of the left main bronchus.
Conclusion : Solitary bronchial papillomas are benign tumors, but surgical removal is
generally recommended because of the possiblility of malignant transformation. Such removal
is especially recommended in patients with a history of previous radiation to relieve the
symptoms or in individuals over 40 with recurrent solitary papillomas. Laser therapy can be
helpful to the inoperable patients by reopening the obstructed bronchi, which relieves the
patients' symptoms and prevents secondary complications.
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