Endobronchial Paraganglioma: AIRP Best Cases in Radiologic-Pathologic Correlation

Abstract

Editor's Note.-RadioGraphics continues to publish radiologic-pathologic case material selected from the American Institute for Radiologic Pathology (AIRP) "best case" presentations. The AIRP conducts a 4-week Radiologic Pathology Correlation Course, which is offered five times per year. On the penultimate day of the course, the best case presentation is held at the American Film Institute Silver Theater and Cultural Center in Silver Spring, Md. The AIRP faculty identifies the best cases, from each organ system, brought by the resident attendees. One or more of the best cases from each of the five courses are then solicited for publication in RadioGraphics. These cases emphasize the importance of radiologic-pathologic correlation in the imaging evaluation and diagnosis of diseases encountered at the institute and its predecessor, the Armed Forces Institute of Pathology (AFIP).

Successful management of tracheal lobular capillary hemangioma with arterial embolization followed by electrosurgical snaring via flexible bronchoscopy in an 11-year-old boy: A case report and literature review

“…In detail, chest CT, especially contrast-enhanced CT, identifies the occupying lesions and reveals the nature of the mass with a plentiful blood supply, while bronchoscopy with biopsy plays a key role in achieving the final diagnosis of tracheal LCH and provides additional opportunities for therapeutic intervention. Endoscopic appearances are non-specific and sometimes may be confused with granulation tissue, carcinoid tumor, Kaposi sarcoma, angioendothelioma, paraganglioma, adenoma, angiosarcoma, intravascular angiomatosis, and carcinoma ( 7 , 8 ). Hence, histopathological findings are crucial for a definite diagnosis of tracheal LCHs.…”

“…There are many theories on pathogenesis revolving around LCH, such as a sequela of local irritation and minor trauma, neovascular response to an angiogenic stimulus with an imbalance of promoters and inhibitors, and bacterial and viral infections (3)(4)(5)(6). As the clinical presentations are various and non-specific, LCH is often confused with true hemangiomas and granulation tissue (7,8). Definitive diagnosis relies on histopathologic examination, which demonstrates a distinctive lobular arrangement of variably sized capillaries embedded in a fibromyxoid matrix without atypical mitoses (2,(9)(10)(11).…”