Mucous gland adenoma of a segment bronchus - Case report
Mucous gland adenoma of the bronchus is a rare benign epithelial tumor. The majority arises from the submucosal seromucous glands and ducts of the proximal airways. In bronchus biopsy specimen it might be difficult to distinguish mucous gland adenomas from low-grade malignant tumors, such as carcinoids, mucoepidermoid carcinomas, or adenoid cystic carcinomas. Complete tumor resection serves for both definite diagnosis and potential curative treatment.
A non smoking man of 78 years suffered from cough, dyspnea and recently from hemoptysis. Fiberoptic bronchoscopy revealed a polypoid, well-circumscribed mass in the right posterior segmental bronchus. A bronchoscopic tumor excision was performed.
Histology and immunohistochemistry (IHC)
The tumor displayed with exuberant dilated cystic glands lined by columnar, cuboidal or flattened mucus secreting cells. IHC was positive for EMA, CKAE1/AE3, and negative for TTF1.
Uncommon benign bronchus adenomas should be taken into account in addition to the common malignant lung carcinomas with endobronchial growth pattern. Endoscopic tumor excision of bronchus adenomas is indicated for potential curative treatment, especially in patients of higher age.
2. Kwon JE, Kim GY, Han J, Kim TS, Kim K: Mucous gland adenoma presenting as a peripheral lung mass: a brief case report. Korean J Pathol 2004; 38: 126–128.
3. Lee B, Choi IH, Han J, Lee KS, Shim YM: An unusual case of pulmonary mucous gland adenoma with fibromyxoid stroma and cartilage islands in 68-year-old woman. Korean J Pathol 2014; 48(2): 167-169
4. Karpathiou G, Sivridis E, Mikroulis D, Froudarakis M, Giatromanolaki A. Pulmonary mucus gland adenomas: Are they always of endobronchial localization? Case Rep Pathol 2013; Vol 2013, Article ID 239173, http://dx.doi.org/10.1155/2013/239173.
5. Méjean-Lebreton F, Barnoud R, de la Roche E, Devouassoux-Shisheboran M: Benign salivary gland-type tumors of the bronchus: expression of high molecular weight cytokeratins. Ann Pathol 2006; 26: 30–34.
6. Milenkovic B, Stojsic J, Mandaric D, Stevic R: Mucous gland adenoma simulating bronchial asthma: Case report and literature review. J Asthma 2007; 44: 789–793.
7. Badyal RK, Kakkar N, Vasishta RM, Mahajan S: Bronchial mucous gland adenoma presenting as massive hemoptysis: A diagnostic dilemma. Lung India 2014; 31(3): 274–276.
8. Yaran P, Gedikoglu G, Dogan R: Mucous gland adenoma of the bronchus: a case report. Turkish J Thorac Cardiovasc Surg 2012; 20(2): 387-389.
9. Courauda S, Isaac S, Guibertd B, Souqueta PJ: Bronchial mucous gland adenoma revealed following acute pneumonia. Interact Cardiovasc Thorac Surg 2012; 14: 347–349.
10. Juarez MM, Albertson T, Chan AL: Interventional bronchoscopy for obstructing benign airway tumors: which modality is ideal. J Thorac Dis 2011; 3(4): 217-218.
11. Dacic S, Gilbert S, Ocak I, Lacomis J. Salivary gland neoplasms of the lung. In: Hasleton P, Flieder DB, eds. Spencer’s pathology of the lung, 6th ed. New York, PA: Cambridge University Press 2013; pp. 1146-1148.
12. Gao Z, Urbanski S. The spectrum of pulmonary mucinous cystic neoplasia. A clinicopathologic and immunohistochemical study of ten cases and review of the literature. Am J Clin Pathol 2005; 124:62-70.
13. Moran CA, Suster S. Benign tumors and tumor-like lesions of the lung. In: Tumors and tumor-like conditions of the lung and pleura, eds, 1th ed. Philadelphia: Elsevier Inc 2010; pp. 351-354
14. Kayser, K. Analytical lung pathology. 1992, Springer, Heidelberg, New York.
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