Maazaoui Sarra, Boubaker Nouha, Mejri Islam, Habibech Sonia, Touil Amany, Mlika Mouna, Racil Hajer, Moatemri Zied, Mezni Faouzi El, Chaouch Nawel
Pulmonology and Interventional Endoscopy Department, Pavilion 2, Abdurrahmen Mami Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia.
Pulmonology Department, Military Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia.
Tanaffos. 2023 Apr;22(4):440-443.
Lobular capillary hemangioma is a benign vascular tumor commonly found within the skin and upper respiratory mucosa and has rarely been reported within the trachea. The first case was reported by Irani et al. in 2003 and since then, less than 20 cases have been described. That's why the characteristics and treatments remain relatively unknown.
A 53-year-old woman was symptomatic of recurrent episodes of hemoptysis associated with paroxysmal dyspnea. Physical examination, routine blood investigations, and chest x-ray were normal. The flexible bronchoscopy showed a polypoid bleeding lesion arising from the right lateral wall of the middle third of the trachea. Tumor biopsy was not performed considering an eventual bleeding risk. Computed tomography scanning showed a vascular, endotracheal budding tissue process without peritracheal or distant extension. A rigid bronchoscopy was performed for diagnostic and therapeutic purposes. A 10-millimeter bronchoscope was used. A rigid coring technique was performed to remove the tumor. A minimal bleeding was completely controlled after diode laser treatment. There were no complications during or after the procedure. Pathology revealed no malignancy and the diagnosis of lobular capillary hemangioma was confirmed. At a 6-month follow-up, the patient was asymptomatic and the endoscopic control did not show any tumor recurrence.
The lobular capillary hemangioma is a benign tumor rarely observed in the trachea. Clinical features are not specific and the short-term prognosis depends on tumor size. Considering its benign nature, tumor removal by interventional bronchoscopy should be proposed as the first-line treatment.
小叶状毛细血管瘤是一种常见于皮肤和上呼吸道黏膜的良性血管肿瘤，在气管内罕见报道。首例病例由伊朗尼等人于2003年报道，自那时起，描述的病例不到20例。这就是其特征和治疗方法仍相对不为人知的原因。
一名53岁女性有反复咯血伴阵发性呼吸困难的症状。体格检查、常规血液检查和胸部X线检查均正常。柔性支气管镜检查显示在气管中三分之一右侧壁有一个息肉样出血性病变。考虑到最终的出血风险，未进行肿瘤活检。计算机断层扫描显示一个血管性的气管内芽状组织病变，无气管周围或远处扩散。为了诊断和治疗目的进行了硬质支气管镜检查。使用了一根10毫米的支气管镜。采用硬质取芯技术切除肿瘤。经二极管激光治疗后，少量出血得到完全控制。手术期间及术后均无并发症。病理检查未发现恶性肿瘤，确诊为小叶状毛细血管瘤。在6个月的随访中，患者无症状，内镜检查未显示任何肿瘤复发。
小叶状毛细血管瘤是一种罕见于气管的良性肿瘤。临床特征不具特异性，短期预后取决于肿瘤大小。鉴于其良性性质，应建议将介入性支气管镜下肿瘤切除作为一线治疗方法。
