Takahara Yutaka, Tanaka Takuya, Nojiri Masafumi, Shinomiya Shohei, Yamada Sohsuke, Mizuno Shiro
Department of Respiratory Medicine, Japan.
Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan.
Respir Med Case Rep. 2022 Feb 18;36:101607. doi: 10.1016/j.rmcr.2022.101607. eCollection 2022.
Laryngeal papilloma is a benign tumor characterized by minimal symptoms; however, in rare cases, it can cause airway obstruction and should be treated with caution. A 65-year-old woman presented to the clinic with a history of dyspnea for the past 20 years. Chest computed tomography revealed the presence of a tracheal diverticulum with an internal septum on the right side of the trachea at the apex of the lung. Upon examination, an otorhinolaryngologist revealed a wart-like tumor at the base of the tongue. However, it was ruled out to be the cause of dyspnea owing to the small size of the tumor. Thereafter, the patient was placed under observation. Brochoscopy was performed to investigate the tracheal diverticulum. Bronchoscopy revealed a pedunculated papilloma entering the glottis because of inhalation in the supine position, indicating a high risk of airway obstruction by the papilloma. The patient underwent papilloma resection. Papillomas must be considered in the differential diagnosis of dyspnea. The risk of airway obstruction should not be underestimated in patients with papilloma with reported history of dyspnea, even in the case of small tumors. The patient had a rare tracheal diverticulum, which further complicated the diagnosis of dyspnea.
喉乳头状瘤是一种症状轻微的良性肿瘤；然而，在罕见情况下，它可导致气道阻塞，应谨慎治疗。一名65岁女性因过去20年的呼吸困难病史前来诊所就诊。胸部计算机断层扫描显示在肺尖处气管右侧存在一个有内部隔膜的气管憩室。经检查，一名耳鼻喉科医生在舌根处发现一个疣状肿瘤。然而，由于肿瘤体积小，排除其为呼吸困难的病因。此后，该患者被置于观察之下。进行了支气管镜检查以研究气管憩室。支气管镜检查显示一个带蒂乳头状瘤因仰卧位吸入进入声门，提示乳头状瘤导致气道阻塞的高风险。该患者接受了乳头状瘤切除术。在呼吸困难的鉴别诊断中必须考虑乳头状瘤。对于有呼吸困难病史报告的乳头状瘤患者，即使肿瘤较小，也不应低估气道阻塞的风险。该患者有一个罕见的气管憩室，这使呼吸困难的诊断更加复杂。
