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Chronic cavitary respiratory papillomatosis
S W Kerley1, C Buchon-Zalles, J Moran
1Department of Pathology and Oncology, University of Kansas School of Medicine, Kansas City.
Archives of Pathology & Laboratory Medicine
|October 1, 1989
Summary
Recurrent respiratory papillomatosis can lead to lung abscesses. Human papillomavirus type 11 DNA was found in squamous-lined cavities, suggesting a role in disease progression.
Area of Science:
- Pulmonology
- Virology
- Pathology
Background:
- Respiratory papillomatosis is a rare disease caused by human papillomavirus (HPV).
- Recurrent cases can lead to significant morbidity, including airway obstruction and secondary infections.
Observation:
- A 19-year-old male presented with recurrent pneumonia and lung abscesses.
- Examination revealed laryngeal papilloma, widespread bronchial papillomatosis, and cavitary lesions in the left lower lobe.
Findings:
- A lobectomy was performed, revealing squamous-lined cavities filled with papillomas.
- In situ DNA hybridization confirmed the presence of human papillomavirus type 11 within the cavities.
- The patient's immune function (humoral and cell-mediated) was within normal limits.
Implications:
- Lung cavitation in this context appears to result from bronchial obstruction, post-obstructive pneumonia, and liquefactive necrosis.
- Squamous metaplasia may facilitate persistent HPV proliferation within these cavitary lesions.
- This case highlights a potential mechanism for severe lung disease in recurrent respiratory papillomatosis.