CTICasesAdult Tracheal Papillomatosis
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Imaging findings
Computed tomography of the chest and trachea reveals multiple discrete, small soft tissue nodular lesions projecting into the tracheal lumen. Bronchoscopy confirms the presence of several exophytic, papillomatous lesions along the tracheal wall, which were subsequently treated with bronchoscopic laser ablation.
Key takeaways
Tracheobronchial papillomatosis is a rare disease in adults, in contrast to the more classic pediatric presentation. In pediatric cases, papillomatosis is frequently associated with maternal transmission of Human Papillomavirus (HPV) and often seeded into the lower airways via tracheostomy, but adult cases are typically localized to the upper airways and may test negative for high-risk HPV serotypes. Adult papillomatosis is usually treated with laser ablation but requires vigilant long-term surveillance because of the risk of dysplastic progression or malignant transformation into squamous cell carcinoma.
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