Elsevier

Respiratory Medicine

Volume 126, May 2017, Pages 116-121
Respiratory Medicine

Review article
Recurrent respiratory papillomatosis: A state-of-the-art review

https://doi.org/10.1016/j.rmed.2017.03.030Get rights and content
Under an Elsevier user license
open archive

Highlights

  • We review the main findings of thoracic involvement in respiratory papillomatosis.

  • Clinical, bronchoscopic and imaging aspects are essential to suggest a correct diagnosis.

  • Helical CT is the standard imaging modality for the assessment of RRP.

  • We also discuss the criteria for differential diagnosis of respiratory papillomatosis.

Abstract

Recurrent respiratory papillomatosis (RRP) is a benign disease of the upper aero-digestive tract caused by human papillomavirus (HPV) infection, which affects children and young adults. The aim of this review is to describe the main etiological, epidemiological, clinical, diagnostic, and treatment aspects of RRP. Most infections in children occur at birth, during passage through the birth canals of contaminated mothers. In adults, HPV is transmitted sexually. Papillomas usually appear as exophytic nodules, primarily in the larynx, but occasionally involving the nasopharynx, tracheobronchial tree, and pulmonary parenchyma. The disease course is unpredictable, ranging from spontaneous remission to aggressive persistent or recurrent disease. Although it occurs rarely, RRP has the potential for malignant transformation to squamous cell carcinoma. Clinically, RRP usually presents with nonspecific symptoms of airway involvement, including chronic cough, hoarseness, wheezing, voice change, stridor, and chronic dyspnea. Helical computed tomography (CT) is highly accurate for the identification and characterization of focal or diffuse airway narrowing caused by nodular vegetant lesions. The typical CT pattern of lung papillomatosis consists of numerous multilobulated nodular lesions of various sizes, frequently cavitated, scattered throughout the lungs. Bronchoscopy is the most reliable method for the diagnosis of RRP; it enables direct visualization of lesions in the central airways and collection of biopsy samples for histopathological diagnosis, and is also useful for therapeutic planning. The definitive diagnosis of RRP is based on histopathological analysis. Currently, no definitive curative treatment for RRP is available; despite the availability of adjunctive treatments, surgery remains the mainstay of treatment.

Keywords

Recurrent respiratory papillomatosis
Computed tomography
Pulmonary diseases

Cited by (0)