A Rare Cause of Cough: Tracheobronchial Myxoid Spindle Cell Lipoma

Abstract

Background. Endobronchial lipomas are a particularly rare form of benign lung neoplasms, with an incidence of 0.1-0.4%. They are often clinically silent, though present with nonspecific symptoms that can result in extensive workup or significant delay prior to diagnosis, as presented in this case. Case Presentation. A 61-year-old male presented with chronic productive cough and occasional dyspnea and a 10-year history of clinically diagnosis of intermittent, exercise-induced asthma, nonresponsive to bronchodilators, and with normal pulmonary function tests. A chest ray showed a band-like opacity in the right middle lobe of the lung and a CT of the chest showed right lung atelectasis with a soft tissue mass in the right main bronchus. The patient underwent bronchoscopy with biopsy, which demonstrated an endobronchial myxoid spindle cell lipoma. The lesion was subsequently removed by a bronchoscopic snare. The patient’s asthmatic-like symptomatology resolved after the mass was excised. Conclusion. Though rare, endobronchial lipomas characteristically present with nonspecific signs and symptoms and thus can be easily mistaken for other medical conditions, delaying diagnosis and prolonging symptoms.

Rare Intra-Thoracic Tumors with Aggressive Potential: Case Series and Literature Review

“…Microscopic examination of myxoid lipomas show spindle shaped cells with scant cytoplasm and uniform nuclei in a myxoid background [16]. On the other hand, liposarcoma shows areas of high vascularity with "chicken wire" pattern and lipoblasts [18,19].…”