The Diagnosis and Treatment of Endobronchial Hamartoma by Cryobiopsy and Therapy via Flexible Bronchoscopy.
A. Teferici*a (Dr), I. Peposhia (Dr), O. Nuredinia (Dr)
a University Hospital Shefqet Ndroqi, Tirana, ALBANIA
* almasakja@hotmail.com
A 68 year old male with complaining of dyspnea for nearly two months was admitted to hospital, department of cardiology for chest pain and transudative right pleural effusion, with ACS diagnosis.He underwent Coronary Angiography test wich resultet negative.
The thorax computerized tomography showed, there is an endoluminal with fat density lesion in the IX segment of the right lower lobe bronchus. In the medastinal space there are no lymph node.
The bronchoscopy examination showed, IX segment of the right lower lobe was obstructed by a round mass.The cryotherapy, endobronchial procedure and tumor cryodebridment was performed.The mas wass successfully removed with small amount of bleeding. At bronchoscopic examination 1 month after removal showed good patency without any obstruction.
The histopathology result of removed mass wass Lipomatous Hamartoma
Endobronchial hamartomas have low frequency between 1.4% and 13,.8%of all pulmonary hamartomas. Most patients with endobronchial hamartomas had at least one of respirtatory complaints due to bronchial obstruction such as obstructive pneumonia cough dyspnea.Although surgical resection has been considered the standart of treatment for endobronchial hamartomas there is an increasing case reports using bronchoscopic treatment.Bronchoscopic cryotherapy is recognized as a useful in endobronchial treatment modality in the palliative management for airway obstruction due to malignancy . It is also useful in management for airway obstruction due to a benign endobronchial lesion. The effectiveness of cryotherapy is limited in long segment ,submucosal tumor. Our case was suitable for cryotherapy because endobronchial tumor attached the bronchus with stalk.We could easily perform the endobronchial biopsy and removal of endobronchial hamartoma usin cryotherapy via flexible bronchoscopy without complication.During and postprocedural period there was no notable complication.Follow up bronchoscopic examination excluded residual or recurrent disease in our case.
In conclusion Cryobiopsy and therapy is safe and less invasive procedure in diagnosis and treatment of endobronchial hamartomas.
Disclosure of funding source(s): none