A 74-year-old woman, without toxic habits, with a history of total thyroidectomy plus lymphadenectomy for papillary thyroid carcinoma treated with sodium levothyroxine and hypercholesterolemia treated with pravastatin.
The patient consulted for cough of 2 months of evolution, whitish expectoration, fever, sweating and dyspnea.
Initially she was treated with two cycles of antibiotics with fever improvement.
Later he began with hemoptoic expectoration, self-limited in the following days.
He did not report general syndrome.
Physical examination revealed a body mass index (BMI) of 38.67, compatible with obesity grade 2 and bilateral roncus irritations.
Laboratory tests showed no abnormalities and Mantoux was negative.
Pulmonary function tests revealed very mild airflow obstruction (forced capacity [FVC] 2,570 cc (110% theoretical value), bronchodilator volume test (92%) in the first second [FEV 67% negative FEV30]).
The chest X-ray showed an increase in density in the right lower lobe (RLD).
Chest computed tomography (CT) showed atelectasis without air bronchogram of the anterior segment of the LID and proximal dilation of the bronchus of this segment, occupied by hypodense material compatible with nodular fat density of 1.6 cm.
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Fiberoptic bronchoscopy revealed a polypoid lesion affecting the basal ganglia of the anterior bronchus.
Bronchial biopsy showed a bronchial proliferation of mature adipose tissue consistent with endobronchial adenocarcinoma.
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Endoscopic treatment with laser resection was decided with endobronchial stenting.
Superficial photocoagulation with laser of the lesion was performed.
A fruitless attempt of diathermy loop extraction was made due to difficulty in seeing the distal part of the lesion, extracting only a part of the lesion, which was sent for anatomopathological analysis.
One month later, a second procedure was performed, and all remaining material was extracted.
No complications were observed after the procedures.
