PMC7277026_01
Poster anterior and lateral chest X-ray: right middle lobe infiltrate, band-like in shape, overlying the anterior cardiac contour.
CRIPU2020-9727281.001.jpg
PMC7277026_01_CRIPU2020-9727281.001.jpg
fig1
Posteroanterior and lateral chest X-ray demonstrated a thin band-like opacity overlying the cardiac contour suggesting atelectasis of the right middle lobe (Figure 1).
CT chest, axial view: red arrow denoting a 15 mm intraluminal, lobulated exophytic soft lesion at the origin of the right middle lobe.
CRIPU2020-9727281.002.jpg
PMC7277026_01_CRIPU2020-9727281.002.jpg
fig2
CT chest, coronal view: red arrow denoting another view of the exophytic soft tissue lesion.
CRIPU2020-9727281.003.jpg
PMC7277026_01_CRIPU2020-9727281.003.jpg
fig3
CT chest, axial view: blue arrow denoting an opacity throughout much of the right middle lobe.
CRIPU2020-9727281.004.jpg
PMC7277026_01_CRIPU2020-9727281.004.jpg
fig4
Flexible bronchoscopy: occlusion of the right middle lobe by a 1 x 1 cm sessile lesion.
CRIPU2020-9727281.005.jpg
PMC7277026_01_CRIPU2020-9727281.005.jpg
fig5
Excisional biopsy of the right middle lobe lesion showing myxoid respiratory tissue with mature adipocytes surrounded by a thick capsule without invasion (a). Characteristic spindle cells with ropey/wavy collagen with interspersed mature adipocytes (b, c), suggestive of a myxoid spindle cell lipoma.
CRIPU2020-9727281.006.jpg
PMC7277026_01_CRIPU2020-9727281.006.jpg
fig6
The patient underwent a second flexible bronchoscopy with snaring forceps for a second biopsy; complete removal of the lesion was performed with pathology reporting endobronchial myxoid spindle cell lipoma (Figure 6).