PMC10165254_01
Chest imaging and bronchoscopic findings for patient 1. 1a: frontal chest radiograph. Circumscribed mass within right tracheobronchial angle. Accompanying widening of paratracheal stripe with mild tracheal deviation to the left and non-visualisation of right main bronchus. 1b: lateral chest radiograph. The mass is located to the middle mediastinum with posterior displacement of the oesophagus. 1c: axial CT (soft tissue window) well defined, heterogeneously enhancing right paratracheal mass with foci of coarse intralesional calcification (arrow). 1d: coronal CT (soft tissue window) paratracheal mass with intraluminal invasion into the right main bronchus (arrow). 1e: bronchoscopic view. Plaque-like lesion at antrum of right main bronchus.
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Frontal and lateral chest radiographs showed a well-circumscribed opacity within the right tracheobronchial angle (Fig. 1a and b). Contrasted CT chest confirmed a well-defined, heterogeneously enhancing right paratracheal mass with foci of coarse intralesional calcification and intraluminal invasion into the right main bronchus (Fig. 1c and d). Flexible bronchoscopy showed an infiltrative mass at the entrance of the right upper lobe bronchus (Fig. 1e).
PMC10165254_02
PMC10165254_03
PMC10165254_04
Imaging, bronchoscopic and histological findings for patient 2. 2a and 2b: frontal and lateral chest radiographs showing collapse consolidation of right middle and right lower lobes with a small accompanying right pleural effusion. 2c: axial CT (soft tissue window), 2d: coronal CT (soft tissue window): homogenously enhancing lobulated intraluminal mass within the right main bronchus (arrow). 2e: coronal CT (lung window) note destruction of right lower lobe and hyperlucent, hyperexpanded right upper lobe. 2f: large, smooth, vascular pedunculated mass in right main bronchus. 2g: low power image of the Haematoxylin and Eosin stain showing a polypoid neoplasm with overlying respiratory epithelium. 2h: tumour arranged as nests and ductal structures with cytoplasmic and luminal mucin. 2i: Cyclin D1 immunohistochemical stain demonstrating nuclear positivity. 2j: Mucicarmine special stain highlights cytoplasmic and luminal mucin.
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Chest radiograph showed collapse consolidation of the right middle and lower lobes (Fig. 2a and b). A CT scan of the chest showed a homogenously enhancing mass with smooth lobulated margins at the origin of right main bronchus (Fig. 2c and d). Parenchymal destruction and varicoid bronchiectasis of the lower lobe was present as well as hyperexpansion of the right upper lobe (Fig. 2e). Flexible bronchoscopy showed a smooth right main bronchial pedunculated mass (Fig. 2f). Immunohistochemistry was positive for CK7 and Cyclin D1 (Fig. 2i-j).
PMC10165254_05