Alveolar adenoma: a rare benign tumour of the lung with a challenging diagnosis (original) (raw)
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Rare Lung Tumors: Alveolar Adenoma-Four Case Reports
Turkish Thoracic Journal, 2019
Alveolar adenoma is one of the rare benign tumors of the lung. It was first described in a six case studies by Yousem and Hochholzer in 1986 [1]. Burke et al. [2] evaluated the clinical and pathological findings of alveolar adenomas with a 17 maturation series. It is usually found in middle-aged women and shows asymptomatic findings in chest radiographs. Overall less than 1% of all lung tumors have been reported to be detected [1-3]. Here, we present four cases (one male and three females) of alveolar adenoma. The patients provided written informed consent for publication. CASE PRESENTATIONS Case 1 A 36-year-old male patient presented to our clinic with a complaint of chest pain. There was no obvious feature in the physical examination and in the patient's history. The blood pressure was 120/80 mmHg, pulse rate was 95/min, body temperature was 36.5°C, and respiration rate was 26/min. The laboratory parameters are within normal limits. A thoracic computed tomography (CT) scan revealed a 26-mm nodule without calcification in the left lower lobe (Figure 1). A fiberoptic bronchoscopy (FOB) examination showed no pathology. A positron emission CT (PET-CT) revealed a 26-mm nodule (SUV-max 2,8) in the left lower lobe of the lung. A diagnosis was not made despite transthoracic fine needle aspiration. Agglutinin tests for hydatid cysts were negative. The forced vital capacity) in the pulmonary function test was 2.8 L, 98%, forced expiratory volume in 1 s was 2.4 L, 93%. The lesion was reported as benign in the thoracotomy-derived frozen section. The pathologic diagnosis was alveolar adenoma (Figure 2). No pathology was found in the 34-month follow-up of the patient. Case 2 A 51-year-old woman was admitted to our clinic with shortness of breath. A posterioranteriorposterior chest X-ray showed uniformly increased density of approximately 2 cm in the right hemithorax subregions. In the thoracic CT, a solitary pulmonary nodule with a diameter of 1.8 cm was localized paravertebrally in the posterior segment of the right upper lobe (Figure 3). The bronchial system was routinely evaluated in the FOB examination. Thoracotomy was performed due to a family history of hydatid cyst. When the lesion was diagnosed as frozen cutaneous benign, thoracotomy was performed through wedge resection. The pathological diagnosis was alveolar adenoma. No pathology was found in the 15-year follow-up of the patient. Case 3 A 38-year-old female patient presented with thoracic hemoptysis and pain. Thoracic CT revealed a 1.3 cm diameter pulmonary nodule in the anterior segment of the right upper lobe. No pathology was detected in the FOB. Thoracotomy was performed because of hemoptysis. The lesion was diagnosed as frozen cutaneous and benign, and thoracotomy was
Alveolar adenoma of the lung: multidisciplinary case discussion and review of the literature
Journal of thoracic disease, 2020
Indeterminate pulmonary nodules detected on imaging are a common management challenge with cases often referred for multidisciplinary discussion to determine the best course of action often a decision between surgical intervention or longitudinal follow-up. Beyond malignancy, there are a number of benign pulmonary nodules that are detected on imaging and present a management dilemma when these lesions are large. Though international guidelines such as that published by the Fleischner society (1) and British Thoracic Society (2) generally recommend surveillance for small incidental solid pulmonary nodules, when solid pulmonary nodules are larger than a centimeter in size there is an increased likelihood to intervene surgically due to an increased risk of malignancy and patient anxiety. Alveolar adenoma is a rare and usually benign pulmonary tumor often discovered incidentally on cross-sectional imaging. Approximately 40 cases have been described in the literature with few reports doc...
Introduction: Alveolar adenomas are extremely rare, benign, primary lung tumors of unknown histogenesis that are characterized by proliferative type II alveolar epithelium and septal mesenchyma. Mostly incidental, they are clinically important as they can imitate benign primary and secondary malignant tumors and at times are difficult to differentiate from early-stage lung cancer. We describe the case of a 59-year-old man with an incidental microscopic alveolar adenoma coexisting with poorly differentiated lung carcinoma. Case presentation: A 59-year-old Caucasian man with a medical history of smoking and chronic obstructive pulmonary disease was incidentally found to have a right upper lobe mass while undergoing a computed tomographic chest scan as part of a chronic obstructive pulmonary disease clinical trial. Our patient underwent a right upper lobectomy after a bronchoscopic biopsy of the mass revealed the mass to be a carcinoma. A pathological examination revealed an incidental, small, 0.2 cm, well circumscribed lesion on the staple line margin of the lobectomy in addition to the carcinoma. Histopathological and immunohistochemical examinations revealed the lesion to be an alveolar adenoma. Conclusions: We report the rare presentation of a microscopic alveolar adenoma coexisting with lung carcinoma. Alveolar adenoma is an entirely benign incidental neoplasm that can be precisely diagnosed using immunohistochemical analysis in addition to its unique histopathological characteristics.
Case report - Pulmonary Alveolar adenoma: an unusual lung tumor
A 34-year-old woman presented with chest pain and a solitary pulmonary nodule on chest roentgenogram. She was diagnosed with a rare benign lung tumor, alveolar adenoma of the lung, through pathological examination of the surgical specimen resected from the left upper lobe. Clinicians should also keep this entity in mind when making the differential diagnosis of a solitary pulmonary nodule. q 2003 Elsevier B.V. All rights reserved.
Journal of Medical Case Reports, 2011
Introduction Alveolar adenomas are extremely rare, benign, primary lung tumors of unknown histogenesis that are characterized by proliferative type II alveolar epithelium and septal mesenchyma. Mostly incidental, they are clinically important as they can imitate benign primary and secondary malignant tumors and at times are difficult to differentiate from early-stage lung cancer. We describe the case of a 59-year-old man with an incidental microscopic alveolar adenoma coexisting with poorly differentiated lung carcinoma. Case presentation A 59-year-old Caucasian man with a medical history of smoking and chronic obstructive pulmonary disease was incidentally found to have a right upper lobe mass while undergoing a computed tomographic chest scan as part of a chronic obstructive pulmonary disease clinical trial. Our patient underwent a right upper lobectomy after a bronchoscopic biopsy of the mass revealed the mass to be a carcinoma. A pathological examination revealed an incidental, small, 0.2 cm, well circumscribed lesion on the staple line margin of the lobectomy in addition to the carcinoma. Histopathological and immunohistochemical examinations revealed the lesion to be an alveolar adenoma. Conclusions We report the rare presentation of a microscopic alveolar adenoma coexisting with lung carcinoma. Alveolar adenoma is an entirely benign incidental neoplasm that can be precisely diagnosed using immunohistochemical analysis in addition to its unique histopathological characteristics.
Alveolar adenoma -- a rare lung tumour
Srpski arhiv za celokupno lekarstvo, 2007
Institut za plućne bolesti i tuberkulozu, Klinički centar Srbije, Beograd KRATAK SADRŽAJ Uvod Al ve o lar ni ade nom pri pa da gru pi be nig nih epi tel nih tu mo ra pluća. Hi sto ge ne za al ve o lar nog ade no ma je kom bi na ci ja umno že nih al ve o lar nih pne u mo ci ta i ve ziv nog tki va ko je po ti če iz sep tal nog me zen hi ma. Prikaz bolesnika Bo le sni ca sta ra 69 go di na pri mqe na je u Insti tut za pluć ne bo le sti i tu ber ku lo zu Kliničkog cen tra Sr bi je u Be o gra du zbog is pi ti va wa i hi rur škog le če wa ja sno ogra ni če ne i ho mo ge ne tu mor ske pro me ne u sred wem re žwu de snog plu ća ko ja je do ve la do ple u ro di ni je. Bron ho skop ski pre gled sa bi op si jom ni je raz ja snio pri ro du pro me ne. Uči we na je tu mo rek to mi ja. Čvor tu mo ra je bio mul ti ci sti čan, a hi sto lo škim, hi sto he mij skim i imu no hi sto he mij skim is pi ti va wem utvr đe no je da je reč o al ve o lar nom ade no mu. Pet go di na po sle ope ra ci je bo le sni ca ne ma te go ba, ni ti zna ko va re ci di va ili ma lig ne al te ra ci je bo le sti. Zakqučak Al ve o lar ni ade nom je be nig ni epi tel ni tu mor plu ća ko ji se naj če šće is po qa va kao pe ri fer ni so li tar ni no dus. Po sle pot pu ne eks ci zi je, al ve o lar ni ade nom ne re ci di vi ra i ma lig no ne al te ri še. Hi rur škom eks ci zi jom tu mo ra po sti že se iz le če we. Ka da se di jag no sti ku je so li tar na pro me na u plu ći ma, tre ba mi sli ti i na ovaj re dak tu mor. Kqučne reči: adenom; plućne alveole; neoplazma pluća
Jornal Brasileiro de Pneumologia, 2006
Alveolar adenoma is a rare benign neoplasm of the lungs, and very few cases have been described in the literature. Patients with alveolar adenoma are frequently asymptomatic and are diagnosed through the accidental discovery of a singular, well-delineated nodule on a routine chest X-ray. The definitive diagnosis is made histologically, and the treatment consists of surgical resection of the nodule..
Alveolar adenoma of the lung: unusual diagnosis of a lesion positive on PET scan. A case report
Journal of Cardiothoracic Surgery, 2012
The authors report a clinical case of alveolar adenoma presenting as a solitary pulmonary nodule which was positive to PET and deeply located in the lung. Few cases of alveolar adenomas have been reported in literature; these lesions are considered pulmonary neoplasms with benign behaviour, usually presenting as a peripheral or subpleural coin lesion; the PET activities of such neoplasms were unknown. The present clinical case was singular for the deep location of the nodule and its tight adhesion to left inferior pulmonary vein requiring a lobectomy. In addition, alveolar adenoma PET behaviour has been reported as light positivity.