View larger version (39K):
[in this window]
[in a new window]
|
A five-year-old girl received the diagnosis of respiratory papillomatosis after an episode of respiratory distress in which the collapse of the right lung required intubation. During bronchoscopy, a single laryngeal papilloma and multiple tracheal papillomas (Panel A) were seen (up to a distance of 1.5 cm above the carina), which partially obstructed the lumen of the airway. In situ hybridization of the pathological specimen with a probe for human papillomavirus serotypes 6 and 11 confirmed that it contained the virus. The patient was treated with interferon and with periodic laser removal of the recurrent laryngotracheal papillomas. Sixteen months later, pulmonary involvement with papillomatosis was evident and was complicated by several pneumonias. Therapy with ribavirin and systemic cidofovir failed. A computed tomographic scan of the chest obtained when the patient was 10 years old showed discrete nodular papillomas (Panel B, arrow) and multiple cavitary lesions in the lung fields. She subsequently died of complications of pneumonia.
|
Previous
