Successful Removal of Endobronchial Lipoma by Flexible Bronchoscopy Using Electrosurgical Snare
A 62-year-old man visited the respiratory outpatient department with symptoms of a chronic cough and atelectasis of the left upper lobe on chest X-ray. The patient had no specific past history and family history. Physical examination revealed clear breath sound without rales and wheezing sound. Laboratory tests were within normal range. Pulmonary function tests revealed a mild obstructive pattern (forced expiratory volume 1 second [FEV1], 96%; FEV1/forced vital capacity, 69%). A chest computed tomography (CT) revealed atelectasis, bronchial wall thickening, stenosis, dilatation, and mucoid impaction in the left upper lobe, without definite mass lesion (). Lymph node enlargements were apparent in the right hilum and left lower paratrachea. Two focal calcified granuloma were seen in the right lung.\nFlexible bronchoscopy was performed and revealed a well-circumscribed mass on the left upper lobe bronchus. Biopsy was done and showed subepithelial mature adipose tissue. We tried to remove a mass with flexible bronchoscopic electrosurgical snare (). After removal of the mass, a base remained on left upper lobe B1+B2. An additional coagulation using snare tip was carried out to the remove residual tumor base and to control the bleeding.\nThe patient was discharged and then followed up in the outpatient department. After 1.5 months, a follow-up bronchoscopy () and chest CT () revealed remaining mass in left upper lobe B2. The remained mass was removed completely by forceps. On follow-up CT scans, atelectastasis was remained but no mass lesion was present in left upper lobe. The patient has been followed up in outpatient department regularly.