An Elderly Woman With Chronic Dyspnea and Endobronchial Lesion Saleh Alazemi, MD, Adnan Majid, MD, FCCP, Angela I. Ruiz, MD, Diana Litmanovich, MD, David Feller-Kopman, MD, FCCP, Armin Ernst, MD, FCCP  CHEST  Volume 137, Issue 2, Pages 460-466 (February 2010) DOI: 10.1378/chest.09-0876 Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 1 Dynamic airway CT scan without IV contrast during inspiration (A - C) and expiration (D and E) at the level of the aortic arch, including mediastinal window (A), lung window (B and D), and virtual bronchoscopy images (C and E). A 1.7 × 1.0 cm polypoid lesion is seen in the dependent portion of the trachea. Dynamic expiratory sequences indicate slight mobility of the lesion and airway collapsibility. The lesion has predominantly soft-tissue attenuation with small foci of low attenuation. CHEST 2010 137, 460-466DOI: (10.1378/chest.09-0876) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 2 Bronchoscopic images of a polypoid yellowish, smooth, and pedunculated lesion in the distal trachea. It appears to arise with a stalk the left posterolateral wall of the trachea. CHEST 2010 137, 460-466DOI: (10.1378/chest.09-0876) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 3 Polypoid mass with broad fronds covered by pseudostratified ciliated columnar epithelium (A). The cores of the fronds are composed of adipose tissue admixed with fibrous connective tissue (hematoxylin-eosin, × 10). Fibrous tissue surrounding lobules of mature adipose tissue (B) (hematoxylin-eosin, × 20). CHEST 2010 137, 460-466DOI: (10.1378/chest.09-0876) Copyright © 2010 The American College of Chest Physicians Terms and Conditions