Endobronchial Glandular Papilloma with Recurrent Empyema and Coexisting Tuberculosis: A Case Report

right-sided pleural effusion with underlying lung collapse and bronchiectatic changes (Figs 1A to F).Diagnostic thoracentesis yielded frank pus, confirming empyema.Intercostal chest drainage evacuated approximately 1.5 L of purulent fluid.Culture grew Pseudomonas aeruginosa, and appropriate intravenous antibiotics were initiated.Although the patient initially improved, she subsequently developed recurrent symptoms with re-accumulation of pleural IntroductIonEndobronchial glandular papillomas are exceedingly rare benign epithelial tumors of the respiratory tract, with the majority arising in the central airways.They are typically classified into three histological subtypes: squamous cell papilloma, glandular papilloma, and mixed squamous and glandular papilloma.1 Among these, glandular papilloma is the least common, with only 35 cases reported in the English-language literature.These tumors are usually endobronchial and are often discovered incidentally during imaging or bronchoscopy performed for unrelated respiratory complaints.Glandular papilloma located within the distal respiratory tract is even rarer, and these can cause obstructive complications like postobstructive pneumonia or empyema. 2 Additionally, in tuberculosis-endemic regions, overlapping clinical and radiological features may obscure the diagnosis.The objective of this case report is to describe the clinicopathological features, diagnostic challenges, and clinical course of a distal endobronchial glandular papilloma presenting with recurrent empyema and coexisting pulmonary tuberculosis, along with a review of the reported literature. case descrIptIonA 42-year-old woman presented with a 6-month history of productive cough, intermittent fever, progressive breathlessness, and right-sided chest pain.There was no previous history of tuberculosis, chronic respiratory disease, significant comorbidities, surgery, or hospital admission.On examination, she was febrile, with stable hemodynamic parameters and an oxygen saturation of 97% on room air.Chest radiography showed opacification of the right hemithorax.Computed tomography of the thorax demonstrated a large