The Natural Course of Endobronchial Inflammatory Polyps as a Complication after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Abstract

We presented a case of unusual endobronchial inflammatory polyps as a complication following endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in a patient with tuberculous lymphadenitis. EBUS-TBNA of the right hilar lymph node was performed in a 29-year-old, previously healthy man. The patient was confirmed with tuberculous lymphadenitis and received antituberculosis medication over the course of 6 months. Chest computed tomography, after 6 months of antituberculosis therapy following the EBUS-TBNA showed nodular bronchial wall thickening of the right main bronchus. Histological and microbiological examinations revealed inflammatory polyps. After 7 months, the inflammatory polyps regressed almost completely without need for removal.

Tracheobronchial puncture-site nodular reaction (TPNR) following endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): Systematic review of case reports

“…Most cases had single lesion, while in two patients, multiple TPNR were present. [ 6 9 ] TPNR resolved spontaneously or with conservative medical management in three of the six patients. Bronchoscopic interventions were performed in three of the six patients (50%) that included rigid bronchoscopy with argon plasma coagulation (APC), cryotherapy, and flexible bronchoscopic biopsy-assisted removal.…”

“…Our systematic review of the literature identified five studies (all case reports) describing six patients wherein a TPNR occurred following EBUS-TBNA. [ 5 6 7 8 9 ] The clinical diagnosis was suspected malignancy in four patients and TB in two patients. A 22-gauge EBUS-TBNA needle was used in three patients whereas the needle gauge was not reported in three patients.…”

“…Instead of a standardized nomenclature, these have been described by various terminologies such as endobronchial inflammatory polyp, endotracheal granuloma, and endobronchial mass formation. [ 5 6 7 8 9 ] Lack of a standardized terminology and rarity of description of such entities may be responsible for underreporting of these reactions. We perform a systematic review of the available literature on these entities, and subsequently propose a term, tracheobronchial puncture-site nodular reaction (TPNR) for these benign reactions that develop subsequent to EBUS-TBNA.…”

A suspected case of inflammatory bronchial polyp induced by bronchial thermoplasty but resolved spontaneously

“…Inflammatory bronchial polyps are developed by epithelialization secondary to bronchial mucosa injury with submucosal extension, such as intubation or thermal injury, and damage to the fibrous connective tissue with the infiltration of inflammatory cells (5,8,9). Although pathological findings could not be evaluated in the current case, a classical inflammatory bronchial polyp is the most likely diagnosis because of its appearance and clinical course (10). However, it remains a matter of speculation.…”

“…The natural course of inflammatory bronchial polyps remains unknown because the majority of them are removed for symptomatic relief (10). Meanwhile, in a case following endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) reported by Lee et al, the inflammatory bronchial polyp regressed spontaneously without treatment (10).…”