endobronchial fibroepithelial polyps are a rare neoplasm with only a few case reports in the english literature ( 1 - 4 ) .
histologically , these lesions are composed of collagen fibers in a stroma covered by normal respiratory epithelium ( 3 ) .
we report a case of a fibroepithelial polyp of the bronchus , of which a lobulating contour is well visualized at computed tomography ( ct ) .
however , a non - contrast chest ct scan ( brilliance 6 , philips healthcare , cleveland , oh , usa ) revealed a 1 cm , endobronchial polypoid nodule abutting the anterior wall of the left main bronchus , which had a soft - tissue attenuation of 40 hu .
the endobronchial nodule showed a conspicuous lobulating contour that resembled an appearance of a blackberry ( fig .
at bronchoscopic examination , a lobulated endoluminal nodule with a glossy surface was arising from the anterior wall of the left main bronchus , resulting in significant luminal narrowing .
the polypoid nodule was removed using an electrosurgical snare during rigid bronchoscopy under general anesthesia . at gross examination of the polypectomy specimen
, the tumor measured 1.2  1.0 cm in diameter with a lobulating contour and a glossy surface ( fig .
histopathologically , the nodule showed marked papillary projections , which resulted in the gross morphology of a lobulating contour of the polyp ( fig
it consisted of fibrovascular stroma covered by normal respiratory epithelium , enabling the histological diagnosis of a fibroepithelial polyp ( fig .
a fibroepithelial polyp is a common type of tumor in the skin or the genitourinary tract .
especially , it is the most common benign tumors of the ureters ( 5 - 8 ) .
however , fibroepithelial polyps of the bronchus are rare with only a few case reports in the english literature ( 1 - 4 ) .
according to these case reports , it manifests as an endobronchial polypoid nodule that is covered with normal respiratory mucosa , consisting of fibrovascular stroma with or without few inflammatory cells and adipocytic components ( 1 - 4 ) .
some reports have classified fibroepithelial polyps as inflammatory , while others have argued that the inflammation is a result of the intermittent respiratory tract obstruction caused by its mass effect ( 4 ) .
histologically , fibroepithelial polyps of ureters are known to be predominantly composed of urothelial epithelium and fibrovascular stroma , showing a finger - like or polypoid growth pattern ( 8) .
such a papillary growth pattern on histology may result in a lobulating contour of the nodule on gross morphology , which can be readily identifiable on radiological images .
the gross appearances of fibroepithelial polyps arising in the tracheobronchial tree and the ureter described in the previous case reports are summarized in table 1 .
the majority of appearances of the polyps suggested their lobulating contours , and many of those figures actually shown in reports revealed quite a similar appearance of the nodules to that of our case . although these appearances had not been emphasized in those reports , the lobulating contour of the polyp was clearly identified on ct images in our case , and this feature had been derived from a typical papillary growth pattern of the fibroepithelial polyp .
it has been known that an endobronchial nodule can develop in a variety of neoplasms including squamous cell carcinoma , adenoid cystic carcinoma , mucoepidermoid carcinoma , neurogenic tumor , leiomyoma , hamartoma and lipoma , and so on .
therefore , we think that an awareness of the implication of such a lobulating contour of an endobronchial tumor might be important in the differential diagnoses of various tracheobronchial polypoid nodules . in summary
, we report a case of a fibroepithelial polyp of the bronchus in which a lobulating contour of the endophytic nodule was well identified at ct scan , and we believe that its lobulating shape represents a typical papillary growth pattern of the tumor on histopathology .
although endobronchial fibroepithelial polyps are a rare neoplasm , such a characteristic lobulating contour of the polyps might be helpful in the differential diagnosis from other various endobronchial polypoid nodules .
 a fibroepithelial polyp of the bronchus is a rare , benign , and endobronchial tumor , histologically consisting of fibrovascular stroma covered by normal respiratory epithelium . 
 we report a case of a fibroepithelial polyp arising from the left main bronchus . 
 on ct , a characteristic lobulating contour of the endobronchial nodule was well visualized , which histopathologically represented a typical papillary growth pattern of the nodule . 
 such a lobulating contour of the nodule might help make a correct diagnosis of this rare disease among other various endobronchial neoplasms . 
INTRODUCTION
CASE REPORT
DISCUSSION