Open AccessBronchial fibroepithelial polyp: a clinico‐radiologic, bronchoscopic, histopathological and in‐situ hybridisation study of 15 cases of a poorly recognised lesion
Author(s) -
Casalini Eleonora,
Cavazza Alberto,
Andreani Alessandro,
Marchioni Alessandro,
Montanari Gloria,
Cappiello Francesca Gaia,
Mengoli Maria Cecilia,
Corradini Paolo,
Agostini Lorenzo,
Serini Roberto,
Rossi Giulio
Publication year - 2017
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12300
Subject(s) - medicine , fibroepithelial polyp , ectasia , bronchoscopy , lesion , pathology , differential diagnosis , asymptomatic , radiology , pathological , ground glass opacity , nodule (geology) , adenocarcinoma , cancer , surgery , paleontology , biology , ureter
Background and Aims Bronchial fibroepithelial polyp is an uncommon, poorly recognised lesion, lacking clear diagnostic criteria at histology, but possibly mimicking neoplastic growth on clinico‐radiologic and histopathological grounds. The aim of this study was to define the clinico‐pathological features, bronchoscopic appearance and treatment of bronchial fibroepithelial polyp. Methods We collected the largest series of bronchial fibroepithelial polyps (15 consecutive cases), including clinico‐pathological, bronchoscopic, radiologic and histological features. Results Overall, there were 13 males and 2 females, with a mean age of 68 years at diagnosis. Eight patients were asymptomatic, whereas four presented with haemoptysis, two with fever, cough and pneumonia‐like opacity, and one with dry recurrent cough. Mean size of the lesion was 6.5 mm (range, 2–20 mm) without any prevalence for segmental bronchi. Lesions larger than 10 mm were always symptomatic and visible at computed tomography scans. At bronchoscopy, the lesion appeared as a firm endobronchial nodule with hard consistency and glistening, whitish, smooth surface. A multilobulated and sepimentated surface was observed in the largest polyps. Whatever the size, histological features were quite similar in all cases, consisting in a polypoid lesion with a dense, collagenous, hypocellular stroma with some thin‐walled, ectatic vessels and a regular respiratory mucosa on surface. In‐situ hybridisation with human papillomavirus probe was negative in all the eight tested cases. Conclusion Despite the benign behaviour of bronchial fibroepithelial polyps, it is important to fix some robust diagnostic criteria in order to avoid misdiagnoses leading to unnecessary aggressive treatment. Differential diagnosis mainly includes inflammatory polyps, hamartomas and papillomas.