A multicenter retrospective study investigating the role of interventional bronchoscopic techniques in the management of endobronchial lipomas.
BACKGROUND
Pulmonary lipomas are rare benign tumors that are usually found endobronchially. Undiagnosed, they can lead to the serious late sequelae associated with endobronchial obstruction. In the majority of cases, they are located in the first three subdivisions of the tracheobronchial tree, and therefore, they are amenable to endoscopic techniques for diagnostic and therapeutic purposes.


OBJECTIVE
It was our aim to retrospectively study the bronchoscopic management and follow-up of a large series of endobronchial lipomas, as well as defining the demographic and endoscopic characteristics of patients.


METHODS
A retrospective multicenter study was performed to identify all cases of lipomas that were treated endoscopically in 4 institutions in the period from 1981 to 2002. Demographic, radiological, endoscopic and histological data were collected.


RESULTS
Thirty-eight patients were included in the study; 81.6% of cases were males and the average age was 63.5 +/- 15.2 years. The majority of the patients were symptomatic (63.2%). Lipomas were located proximally in 18 cases (47.4%) and distally in 20 subjects (52.6%). Specimens obtained by rigid bronchoscopy were diagnostic in all cases. Thirty-six out of 38 patients underwent therapeutic rigid bronchoscopy. Laser and mechanical debulking was performed in 29 cases (76.3%), cryotherapy and mechanical debulking in 7 subjects (18.4%), and mechanical debulking alone in 2 cases (5.3%). No cases of recurrence occurred during the follow-up period.


CONCLUSIONS
This study demonstrates that endoscopic techniques are effective for the diagnosis and treatment of endobronchial lipomas when there is no evidence of severe distal bronchiectasis. This should be the treatment of choice after a full clinicoradiological evaluation.
Nassiri
A H
AH
Department of Chest Diseases and Thoracic Oncology, Hôpital Nord, Hôpitaux Universitaires de Saint-Etienne, Saint-Etienne, France.
Dutau
H
H
Breen
D
D
Colchen
A
A
Quiot
J J
JJ
Nguyen
B
B
Vergnon
J M
JM
D000368:Aged; D001707:Biopsy, Needle; D001984:Bronchial Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D001999:Bronchoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008067:Lipoma / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome