Recurrent laryngeal papillomatosis with bronchopulmonary spread in a 70-year-old man.

Recurrent laryngeal papillomatosis (RRLP) which is characterized by wart like growths in the larynx is a rare benign disease seen in children and young adults and a few cases are reported in old aged adults. The spread of RRLP throughout the respiratory tract occurs rarely; and involvement of the distal bronchi, bronchioles, and lung parenchyma is very rare. We report a case of tracheobronchial and pulmonary spread of RRLP in a 70-year-old man after two previous surgeries. Despite the rarity of this disease in adults, the correct diagnosis may be suggested by a characteristic combination of clinical, radiographic, and pathologic features.

Primary endobronchial actinomycosis simulating endobronchial tuberculosis in a patient with diabetes mellitus.

Primary endobronchial actinomycosis is rare and very uncommon without foreign body aspiration. A 70-years old nonsmoker diabetic woman was presented with hemoptysis and weight loss for two months. Fiberoptic bronchoscopy was performed because of hilar mass on her computerized tomography scan, with a presumptive diagnosis of bronchial carcinoma. It demonstrated vegetations in left upper lobe bronchus. Histologic examination of the biopsy specimen demonstrated Actinomyces infection. The patient responded well to penicillin therapy and chest X-ray completely cleared in four months. To our knowledge, the association of endobronchial actinomycosis with diabetes mellitus without presence of a foreign body has not been reported previously, and should be included in differential diagnosis with endobronchial tuberculosis or cancer in endobronchial vegetations.