Recurrent respiratory papillomatosis: Cytopathological findings in an unusual case

Abstract

Recurrent respiratory papillomatosis (RRP) primarily is a disease of children and adolescents. Most patients experience spontaneous regression at a later age, while others continue to be affected throughout their lives. Here, we present the case of a 26-yr-old man who presented with persistent cough, worsening dyspnea, and development of pneumothorax. Eight years prior, he had presented with similar complaints and an evaluation at that time had showed RRP. Follow-up since that time showed recurrent disease managed by multiple surgical procedures. At the most current admission, an ultrasound-guided fine-needle aspiration (FNA) of the lung showed numerous papillary tissue fragments and single atypical squamous cells consistent with recurrent RPR. To our knowledge, morphological findings of RRP have been reported rarely.

Recurrent respiratory papillomatosis with pulmonary involvement: A case report and review of the literature

“…The characteristic lesions identified on CXR are bilateral, multiple thin‐walled cysts and nodular papillomas. Some reports emphasized predominant lower lobe distribution, but involvement of the upper lobes is not uncommon 9,11 . The cyst walls are usually smooth but asymmetric thick walls (2–3 mm) are seen occasionally 10 .…”

“…Cysts are usually less than 5 cm diameter in size 8 . Air‐fluid level in cysts is not uncommon 8–11 . The papillomas in the lungs, either nodules or masses, often have lobulated margins.…”

“…Some reports emphasized predominant lower lobe distribution, but involvement of the upper lobes is not uncommon. 9,11 The cyst walls are usually smooth but asymmetric thick walls (2-3 mm) are seen occasionally. 10 Cysts may be round or irregular in shape, and cysts with irregular contours often have thicker walls.…”

“…8 Air-fluid level in cysts is not uncommon. [8][9][10][11] The papillomas in the lungs, either nodules or masses, often have lobulated margins. Nodular lesions (< 3 cm in diameter) have been reported to be more common than masses.…”