Richter's transformation presenting as an obstructing endobronchial lesion

A 60-year-old man with chronic lymphocytic leukemia presented to our. institution with a recurring lingular pneumonia. On fiberoptic bronchoscopy, the patient was found to have an endobronchial mass obstructing the lingula and left upper robe. Biopsy specimens of the mass demonstrated anaplastic large cell lymphoma consistent with Richter's transformation. Only one case of endobronchial Richter's transformation has been previously reported in the literature. This was described as peribronchial and endobronchial leukemic infiltrates within the bronchial mucosa, We report the first case of an obstructive endobronchial mass secondary to Richter's transformation. The endobronchial mass was treated with a Nd-YAG laser to maintain airway patency while the patient underwent chemotherapy, resulting in complete resolution of the mass within the airway.