Glanduläres Papillom im linken Hauptbronchus – eine extrem seltene bronchoskopische Diagnose

Zusammenfassung

Wir berichten über einen 81-jährigen Patienten, der sich zuvor in gutem, kardiopulmonal beschwerdefreiem Allgemeinzustand befunden und innerhalb von ca. 10 Tagen progrediente Dyspnoe und Hämoptysen entwickelt hatte. Ursächlich war ein subtotal den linken Hauptbronchus verschließender, exophytisch wachsender Tumor. Unter der Verdachtsdiagnose eines Lungenkarzinoms erfolgte dessen endoskopische Abtragung. Er erwies sich jedoch histopathologisch als glanduläres Papillom. Dieses ist systematisch in die variable Gruppe der benignen Lungentumore, genauer: in die von respiratorischem Epithel abstammenden solitären Papillome, einzuordnen. Glanduläre Papillome sind extrem selten: Weltweit sind bisher weniger als 50 Fälle dokumentiert. Entsprechend knapp ist die empirische Basis zu ihren Eigenschaften und der adäquaten Diagnostik und Therapie. Der Beitrag systematisiert die bisherigen Erkenntnisse und setzt sie in Beziehung zum aktuellen Fall. Die differenzialdiagnostische Abgrenzung des glandulären Papilloms von sonstigen solitären Papillomen und Lungenkarzinomen ist schwierig, entscheidend ist hier die histopathologische Charakterisierung. Zur Optimierung der diagnostischen Ausbeute und Schaffung eines ausreichenden Sicherheitsabstands sollte eine möglichst vollständige Abtragung erfolgen. Falls möglich, ist das endoskopische Vorgehen die Methode der Wahl.

Abstract

We present the case of an 81-year-old patient who had previously been in a good general, cardiopulmonary symptom-free condition before developing progressive dyspnea and hemoptysis within about 10 days. The underlying cause was an exophytically growing tumor which occluded the left main bronchus. Under the suspected diagnosis of lung cancer, the tumor was endoscopically removed. Histopathologically, however, it proved to be a glandular papilloma. The latter belongs to the variable group of benign lung tumors, more precisely: to the solitary papillomas originating from respiratory epithelium. Glandular papillomas are extremely rare: So far, less than 50 cases have been documented worldwide. Thus, the empirical basis for assessing their characteristics and their adequate diagnosis and treatment is scarce. This paper systematizes the findings to date and relates them to the current case. The differential diagnosis of glandular papillomas from other solitary respiratory papillomas, as well as from lung carcinomas, is difficult. Histopathology is crucial for the definite diagnosis. For ensuring a representative amount of material and maximum safety, glandular papillomas should always be removed as completely as possible. If feasible, the endoscopic procedure is the method of choice.

Schlüsselwörter

glanduläres Papillom - solitäre Papillome - benigne Lungentumore - Bronchoskopie - Hämoptysen - Kryoextraktion

Keywords

glandular papilloma - solitary respiratory papilloma - benign lung tumors - bronchoscopy - hemoptysis - cryoextraction

Publikationsverlauf

Eingereicht: 17. Mai 2025

Angenommen: 28. Juli 2025

Artikel online veröffentlicht:
12. August 2025

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