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Author Spotlight: Learning Systematic Bronchoscopy in a Simulation-Base Setting
Published on: June 23, 2023
Bronchial squamous cell papilloma incidental finding in bronchoscopy following prolonged ventilator weaning: A case
Hendris U C Wahyudin1, Didik S Heriyanto2,3, Brigitta N Halim2
1Department of Internal Medicine, Division of Pulmonology, Dr. Sardjito General Hospital, Yogyakarta, Indonesia.
Abstract:
Bronchial squamous cell papilloma (BSCP) is an uncommon tumor seen in the bronchi, while squamous cell papillomas are frequently observed in different organs. The fortuitous detection of BSCP underscores the significance of comprehensive diagnostic assessments for respiratory conditions. This case details the situation of a 37-year-old, non-smoking female who was referred to our center due to seizures. After a three-week hospital stay, attempts were made to wean her off ventilator support. However, the patient experienced difficulties during spontaneous breathing trials. A bronchoscopy was performed to ascertain the etiology of these challenges, uncovering whitish polypoidal tumors with uneven surfaces. A forceps biopsy was conducted on the tumor, and histological examination revealed squamous epithelial cells without any atypia cells. Subsequent HPV DNA testing definitively identified the presence of HPV type 11, leading to the diagnosis of BSCP in the patient. This example highlights the crucial significance of bronchoscopy and histological testing in the detection and verification of uncommon benign lesions, enabling prompt and efficient treatment. While HPV infection associated with BSCP may be correlated with immunocompromised conditions, it was not directly connected to the extended process of weaning the patient off the ventilator. Performing regular bronchoscopy in individuals with impaired immune systems is crucial for the timely identification of non-cancerous abnormalities and the prevention of their advancement. The results of this case emphasize the importance of conducting routine diagnostic procedures to effectively manage respiratory diseases and provide appropriate care for patients.
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