Head and Neck

Multimodality bronchoscopic imaging of recurrent respiratory papillomatosis

  1. Henri G. Colt MD1,*,
  2. Septimiu D. Murgu MD1,
  3. Bockhyun Jung MD3,
  4. Yeh-Chan Ahn PhD2,
  5. Matt Brenner MD1,2

Article first published online: 18 NOV 2009

DOI: 10.1002/lary.20780

Issue

The Laryngoscope

The Laryngoscope

Volume 120, Issue 3, pages 468–472, March 2010

Additional Information

How to Cite

Colt, H. G., Murgu, S. D., Jung, B., Ahn, Y.-C. and Brenner, M. (2010), Multimodality bronchoscopic imaging of recurrent respiratory papillomatosis. The Laryngoscope, 120: 468–472. doi: 10.1002/lary.20780

Author Information

  1. 1

    Pulmonary and Critical Care Medicine, Department of Medicine, University of California School of Medicine, Irvine, California, U.S.A

  2. 2

    Beckman Laser Institute, University of California, Irvine Irvine, California, U.S.A

  3. 3

    Department of Internal Medicine, Pulmonary and Critical Care Medicine, University of Ulsan, Gangneung Asan Hospital, Gangneung, South Korea

*UCI Medical Center, 101 The City Drive South, Bldg. 53, Rm. 119, Rt. 81, Orange, CA 92868

Publication History

  1. Issue published online: 16 FEB 2010
  2. Article first published online: 18 NOV 2009
  3. Manuscript Accepted: 15 OCT 2009
  4. Manuscript Revised: 13 OCT 2009
  5. Manuscript Received: 21 SEP 2009

Funded by

  • National Institutes of Health. Grant Number: #CA 124967)
  • California TRDRP. Grant Number: 16RT-0082

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Keywords:

  • Bronchoscopy;
  • optical coherence tomography;
  • endoscopic ultrasonography;
  • papillomatosis

Abstract

Objectives/Hypothesis.

Recurrent respiratory papillomatosis (RRP) of the central airways requires removal to potentially reduce recurrence and risk for malignant transformation. Analogous to the principles of treatment for early lung cancer, a precise determination of the extent of cartilage invasion could help guide therapeutic decisions and monitor response to treatment. The purpose of this study was to determine whether a bronchoscopy platform comprised of white light bronchoscopy (WLB), endobronchial ultrasound (EBUS), and optical coherence tomography (OCT) could identify layered microstructure of RRP and underlying cartilage.

Study Design.

Case study.

Methods.

A bronchoscopy platform consisting of commercially available WLB, EBUS using a 7.5 MHz convex probe (BF-UC 160F; Olympus Optical Co. Ltd, Tokyo, Japan), and a time-domain OCT with front imaging and inside actuation (Niris Imaging System; Imalux Corp., Cleveland, OH) was used in a patient with tracheal stenosis from RRP. Findings are compared with results of histology and the characteristics of imaging modalities are discussed.

Results.

WLB revealed tracheal pedunculated lesions. EBUS showed a 1-cm hypoechogenic density corresponding to the papilloma, visualized above a hyperechogenic density corresponding to tracheal cartilage. There was no sonographic evidence of cartilage disruption or adjacent lymphadenopathy. OCT revealed a layer of heterogeneous light backscattering suggesting the mucosal papilloma, and a layer of high-degree scattering, corresponding to the central fibrovascular core noted on histology.

Conclusions.

Layered microstructures of RRP and underlying airway cartilage can be identified using a combination of acoustic and optical bronchoscopic imaging modalities with different resolution and depth of penetration characteristics. Laryngoscope, 2010

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