Figure 1. Chest roentgenogram.
Figure 2. Contrast enhanced computer tomography of chest.
A 24-year-old man with recurrent respiratory papillomatosis presented with a history of breathlessness and a change in voice for the last four months. He had undergone endoscopic debridement in the past for laryngeal papillomatosis. On initial evaluation, respiratory distress was thought to be due to recurrence of laryngeal papillomatosis as he improved after surgical de-bulking of laryngo-tracheal papillomas. However, he had some trickle of blood into bronchi with debridement under general anaesthesia. Post-operative chest roentgenogram showed bilateral patchy opacities giving the appearance of aspiration pneumonitis as shown in figure 1.
He also underwent contrast enhanced computer tomography of the chest which showed numerous but small cavitary lesions involving bilateral lung parenchyma as shown in figure 2. This lead to the diagnosis of pulmonary spread of laryngeal papillomatosis and the patient was given adjuvant treatment for this aggressive disease (1,2).
Devaraja K, MS, DNB and Kapil Sikka, MS, DNB
All India Institute of Medical Sciences
Ansari Nagar, New Delhi, India
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