Benign Bronchial Tumours: A Rare Case of Endobronchial Fibroma With Hilar-Mediastinal Lymphadenopathy.

BACKGROUND

Endobronchial fibroma is a rare benign tumour that can mimic lung cancer, especially when accompanied by airway obstruction and hilar-mediastinal lymphadenopathy.

CASE PRESENTATION: A 73-year-old man under radiological surveillance for pulmonary nodules developed interval growth of a middle-lobe nodule with new hilar-mediastinal lymphadenopathy and an obstructing B4 endobronchial mass. Bronchoscopy revealed a smooth, firm, rubbery polypoid lesion. Tissue sampling included fine-needle aspiration of the endobronchial mass and EBUS-TBNA of nodal stations (7, 11Ri and 11 L). Histology showed fibromatous tissue without atypia; lymph nodes exhibited inflammatory changes. The lesion was fully removed via rigid bronchoscopy with forceps and laser, leading to symptom relief and planned radiological follow-up. We propose a stepwise evaluation pathway for endobronchial tumours when lymphadenopathy is present, highlight pathology features that distinguish fibroma from malignant and benign mimickers and outline practical considerations for bronchoscopic resection.

CONCLUSION

In patients with concurrent endobronchial mass and lymphadenopathy, a targeted approach using EBUS-TBNA can exclude nodal metastasis and support definitive, minimally invasive treatment, potentially avoiding unnecessary surgery.