Large Endobronchial Enchondroma with Bronchopulmonary Aspergillosis & Fibrocavitation of the Lung

We report a case of a patient with an endobronchial mass in the left main bronchus of the lung, presenting with recurrent pneumonia and hemoptysis. Initial bronchoscopic investigations and endobronchial tissue biopsy had been non-specific, suggestive only of a fibroepithelial polyp. However, in consideration of the recurrent nature of the patient’s symptoms over the years, he was advised to undergo a left pneumonectomy. Tissue biopsy sent post-operatively revealed the presence of multiple upper lobe cavities with fungal colonies caused by Aspergillosis, with the endobronchial mass showing features of benign endobronchial enchondroma. Based on the clinical history, and histopathological findings, patient has been started on oral Itraconazole. Follow-up, 1 month postoperatively, and 2 weeks since starting medication shows stable results, with no sign of adverse events. This case highlights the importance of regular follow-ups and repeat tissue biopsies, where required, of endobronchial lesions, especially in high-TB burden countries like India.