Tracheal Spindle Cell Lipoma: A Case Report

Spindle cell lipoma (SCL) is a rare benign adipocytic tumor that typically arises in the subcutaneous tissue of the posterior neck, shoulder, and upper back. Occurrence in the airway is exceedingly rare, with only a few cases reported in the literature.

A 39-year-old man presented with an 8-month history of progressive cough and dyspnea on exertion. CT revealed a tumor occupying the tracheal lumen. Rigid bronchoscopy demonstrated a well-defined, smooth-surfaced, mobile tumor arising from the right lateral tracheal wall. The tumor was removed by rigid bronchoscopy, and no visible residual lesion was observed bronchoscopically after resection. Histopathological examination showed bland spindle cells admixed with mature adipocytes and ropey collagen bundles. Immunohistochemical analysis demonstrated diffuse CD34 positivity, supporting the diagnosis of SCL.

SCL can rarely arise in the airway and may cause clinically significant airway obstruction despite its benign histology. Preoperative diagnosis by bronchoscopic biopsy may be difficult, as these lesions are typically well-circumscribed and smooth-surfaced. Therefore, this entity should be considered in the differential diagnosis of benign-appearing airway tumors, and timely intervention may be required to prevent potential airway compromise.