Endobronchial lipomas: a clinicopathologic study of four cases

Four cases of endobronchial lipomas are presented. The patients were men between 45 and 54 yr of age. Clinically, two of the patients presented with cough and one with shortness of breath. Two lesions were located in the left lower lobe, one in the right upper lobe, and one in the right lower lobe. Because of the clinical suspicion of malignancy, all patients underwent radical surgical procedures; lobectomy was performed in 3 patients, and pneumonectomy in one. Grossly, all the lesions were characterized by well-circumscribed, soft, yellow nodules that ranged in size from 1.2 to 3.0 cm in greatest diameter. Histologically, the tumors resembled lipomas in other locations, i.e., they were composed of mature adipose tissue devoid of atypia. In two cases, prominent spindle cell areas were also present similar to those of spindle cell lipoma. Identification of the lesion by endoscopic and radiologic means may help avoid unnecessary radical surgery. A review of the literature on these unusual lesions is presented along with a discussion of their differential diagnosis.