Inflammatory myofibroblastic tumour: a rare cause of central airway obstruction

Description

A 70-year-old woman with no comorbidities presented with cough, wheezing, exertional dyspnoea and a sensation of throat fullness. She never smoked and was recently diagnosed with asthma based on a normal chest radiograph and pulmonary function testing but failed to improve with bronchodilators and steroids. Her initial chest radiograph was unremarkable, and spirometry suggested a fixed intrathoracic obstruction. CT of the chest obtained after 2 months showed an irregular density in the trachea, 1.4x1.7 cm (figure 1). Flexible bronchoscopy showed a polypoid mass 2–3 cm above the carina adherent to the right wall of the trachea (figure 2). Rigid bronchoscopy with neodymium-doped yttrium aluminium garnet (Nd:YAG) laser photoresection was performed. Given the vascular nature of the tumour, removal was complicated by significant bleeding, which required endobronchial epinephrine and laser coagulation. The patient recovered without further complications. Immunohistochemical staining on the excised tumour was positive for vimentin...

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