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Trachea

Tumors

Papilloma / Papillomatosis

Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 8 February 2013, last major update October 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Benign squamous lesion similar to laryngeal lesions, due to infection with HPV6, HPV11 (Chron Respir Dis 2011;8:233, J Med Virol 2004;72:473)

Clinical features
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● Juvenile and adult onset
● Symptoms: cough, hemophtysis
● May disappear spontaneously
● May occur in patient with primary biliary cirrhosis, Cowden disease, tuberculosis
● Cases associated with laryngeal lesions have low incidence of malignant transformation
● Cases limited to trachea and bronchi usually begin in adults, have higher incidence of malignant transformation
● Tracheotomy is associated with progression of laryngeal papilloma into trachea (Zhonghua Er Bi Yan Hou Ke Za Zhi 2000;35:384)

Case reports
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● 27 year old man with large papillary mass and invasive component (Am J Surg Pathol 1980;4:79)
● 42 year old woman with multiple papillomatous-like tumors involving the trachea and bronchi (Chest 1983;83:817)
● 52 year old woman with breathlessness on exertion (Ann Thorac Surg 2004;77:2201)
● 57 year old man with malignant transformation of solitary papilloma (Can Respir J 2008;15:375)
● 58 year old man with Cowden's disease (Intern Med 2006;45:987)
● 66 year old man with recurrent papilloma (Asian J Surg 2007;30:88)
● 72 year old woman with multiple squamous papillomas (Intern Med 2008;47:1535)

Treatment
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● HPV vaccine (to prevent); medical therapy, multiple surgery if recurrence

Micro description
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● Usually benign squamous, intermediate and ciliated cells overlying fibrovascular stroma
● Invasive tumor may have intracystic papillary structures, atypical invasive epithelium

Micro images
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Laryngeal papilloma

Differential diagnosis
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● Oat cell carcinoma: looks similar at bronchoscopy

End of Trachea > Tumors > Papilloma / Papillomatosis

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