CTICasesRespiratory Papillomatosis with Malignant Transformation
Imaging findings
Serial chest CT scans in a young patient with a history of recurrent respiratory papillomatosis show progressive development of bilateral, thin-walled, air-filled cavities in the lower lung zones. Over time, these progress to lobar collapse (left lower lobe) and a rapidly growing, infiltrative soft-tissue mass in the right upper lobe, confirmed to represent invasive squamous cell carcinoma.
Key takeaways
Recurrent respiratory papillomatosis is a rare disease caused by human papillomavirus (HPV) infection, characterized by benign papillomas of the larynx and airways. While rare, distal lung parenchymal spread can occur, presenting as multiple thin-walled cysts. These cysts have a high risk of undergoing malignant transformation into invasive squamous cell carcinoma, carrying a very poor prognosis and requiring close radiological surveillance.
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