1/14. Case report: two cases of biliary papillomatosis with unusual associations.Papillomatosis arising from the biliary tree is a well recognized but rare entity. We encountered two patients with this condition. However, one of them had associated hepatocellular carcinoma and cirrhosis and the other had concomitant recurrent pyogenic cholangitis. To our knowledge, these associations have not been reported before. We, therefore, present these clinical problems and highlight the added difficulty in the management of these patients.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/14. Fine-needle aspiration cytologic diagnosis of intrahepatic biliary papillomatosis (intraductal papillary tumor): report of three cases and comparative study with cholangiocarcinoma.Biliary papillomatosis is a rare tumor of the intrahepatic and extrahepatic biliary tree, and its FNA findings have not been reported. The cytologic features of 3 cases of intrahepatic biliary papillomatosis were studied and compared with 5 cases of cholangiocarcinoma. The distinctive features include: 1) hypercellular smear, 2) very broad and often double-cell layered sheets of ductal columnar epithelium, 3) papillary configuration, 4) preserved honeycomb pattern with even nuclear spacing, and 5) dysplastic but not frankly malignant nuclear features. The constellation of these features is highly characteristic of biliary papillomatosis and helpful in distinguishing it from cholangiocarcinoma and other differential diagnoses. A firm preoperative diagnosis can thus be achieved, allowing better planning in management of this borderline malignant tumor.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/14. Fractured tracheostomy tube in the tracheo-bronchial tree.tracheostomy is a life saving procedure and many a times patients are discharged with permanent tracheostomy tubes. However, fracture of tracheostomy tube with subsequent migration into the tracheobronchial tree is uncommon and carries the potentially fatal risk of respiratory obstruction. In this report, a case of a 6-year-old boy is presented, who had aspirated a fractured tracheostomy tube which had lodged in the left bronchus.- - - - - - - - - - ranking = 5keywords = tree (Clic here for more details about this article) |
4/14. Virtual bronchoscopy for diagnosis of recurrent respiratory papillomatosis.Virtual bronchoscopy is a new method for viewing helical/spiral computed tomography (CT) images of the tracheobronchial trees. Using commercially available software to process the CT data, the tracheobronchial trees can be inspected through a series of three-dimensional images. Recently, this technique has been increasingly used to detect benign and malignant airway stenosis. We report the findings of virtual bronchoscopy in a 41-year-old man with recurrent respiratory papillomatosis (RRP). Several tiny nodules were evident in the lower trachea. Fiberoptic bronchoscopy was performed 1 month later during a planned surgery for laryngeal papillomas, and the findings were in agreement with virtual bronchoscopy. Detection of intrabronchial spreading in RRP is important since peripheral seeding of RRP can cause complications, including recurrent pneumonia, obstructive atelectasis, hemoptysis, and, rarely, may degenerate to squamous cell carcinoma. Virtual bronchoscopy is an alternative method for inspecting the tracheobronchial trees in patients with RRP when laryngeal papillomas impede fiberoptic bronchoscopy.- - - - - - - - - - ranking = 3keywords = tree (Clic here for more details about this article) |
5/14. Endobronchial and parenchymal juvenile laryngotracheobronchial papillomatosis. Effect of photodynamic therapy.Juvenile laryngotracheobronchial papillomatosis (JLTBP) is a recurrent, prolonged disease usually confined to the upper airway. Rarely, tracheobronchial tree or lung parenchymal involvement occurs. The various therapeutic interventions are often unsuccessful once extralaryngeal involvement becomes apparent. Photodynamic therapy (PDT) has been successful in eradicating JLTBP in a few case reports. We present a case of extensive JLTBP with parenchymal involvement treated with multiple courses of PDT. We demonstrated temporary regression of endobronchial papillomas, but no change in parenchymal lesions. Recurrent endobronchial disease was most likely related to reinfection from parenchymal lesions inaccessible to PDT.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
6/14. Squamous carcinoma of the lung in a nonirradiated, nonsmoking patient with juvenile laryngotracheal papillomatosis.Juvenile laryngotracheal papillomatosis (JLTP)--a disease characterized by the growth of multiple, recurrent, koilocytolic papillomas of the upper respiratory tree--occurs in 1,500 to 2,000 infants and children in the united states every year. In rare instances, the papillomas, which are thought to be caused by a human papillomavirus (HPV), may extend into the distal bronchi and lungs. They are often excised surgically or by laser resection, but may regress spontaneously. patients who receive radiation or cytotoxic drugs for this condition, or subsequently become smokers, may be predisposed to the development of bronchopulmonary carcinoma. Only six cases of bronchopulmonary carcinoma arising in persons with a history of JLTP but no history of these predisposing factors have been reported. Herein, we report the occurrence of squamous carcinoma of the left lung in a 28-year-old woman with JLTP since the age of 2 1/2 years. The carcinoma as well as randomly chosen papillomas excised over a period of years demonstrated positive nuclear staining for papillomavirus structural antigen. This is consistent with the current belief that human papillomavirus may be an important factor in the development of squamous carcinomas in various anatomic locations.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
7/14. Massive oropharyngeal papillomatosis causing obstructive sleep apnea in a child.Obstructive sleep apnea in children is most often secondary to severe adenotonsillar hypertrophy. A 5 1/2-year-old boy presented with loud snoring, increasing dysphagia, nocturnal choking, and apnea. Extensive papillomatosis of the uvula, soft palate, and nasopharynx was found to be causing the obstruction. Although multiple papillomas of the larynx and tracheobronchial tree are well known, the occurrence of extensive papillomas of the oral cavity is rare. The unusual clinical presentation and pathologic significance are discussed.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
8/14. Invasive papillomatosis and squamous carcinoma complicating juvenile laryngeal papillomatosis.Juvenile laryngeal papillomatosis (JLP), usually a benign, self-limited disease, occasionally has a highly aggressive course characterized by extension of neoplastic cells into the tracheobronchial tree, lung, and soft tissues. Less frequently, squamous carcinoma has arisen in JLP, most commonly following radiation therapy. Rarely, carcinoma has occurred without previous irradiation, but distant metastases do not generally occur. We describe a 14-year-old boy, with a particularly aggressive form of JLP, who developed invasion of the lungs, intrapulmonary lymph nodes, and arteries by cytologically benign neoplastic tissue. He also developed a metastasizing squamous carcinoma of the lung and humoral hypercalcemia of malignancy. A discussion of the implications of the case and a review of the current literature are provided.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
9/14. Oat cell carcinoma with multiple tracheobronchial papillomatous tumors.Multiple papillomas of the tracheobronchial tree are rare in children and adults. We describe a 42-year-old woman with multiple papillomatous-like tumors involving the trachea and bronchi. The limited tissue samples obtained during fiberoptic bronchoscopy initially lead to a benign histopathologic diagnosis; concurrent cytology studies strongly suggested oat cell carcinoma. The biopsy specimen obtained by rigid bronchoscopy ultimately demonstrated unequivocal oat cell carcinoma. This case illustrates an unusual and previously unreported manifestation of oat cell carcinoma--an endoscopic presentation in a papillary form suggesting benign tracheobronchial papillomatosis. Cytology studies were of increased diagnostic significance in this clinicopathologic setting.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
10/14. Papillomas of the tracheobronchial tree with malignant degeneration.Papillomas are rare tumors of the respiratory tract, which are usually considered benign. We studied a male patient with adult onset of squamous papillomatosis involving both the trachea and the bronchi, with malignant degeneration. When we obtained specimens bronchoscopically, only the bronchial lesions showed carcinomatous changes. thoracotomy demonstrated carcinoma in the tracheal lesion as well. We conclude that transbronchoscopic biopsy may be inadequate in the evaluation of papillomatosis.- - - - - - - - - - ranking = 4keywords = tree (Clic here for more details about this article) |
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