An unusual case of a microscopic alveolar adenoma coexisting with lung carcinoma: a case report and review of the literature (original) (raw)
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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 benign tumour of the lung with a challenging diagnosis
Turkish Journal of Pathology, 2021
Alveolar adenoma is a rare lung benign tumour originating from type II pneumocytes. It presents as a well-defined nodule. In some cases, it is difficult to differentiate from lung cancer. Few cases of this tumour have been reported. We describe here a case of alveolar adenoma in a 63-year-old man discovered incidentally on chest X-ray. The lesion was reported as lepidic adenocarcinoma in bronchoscopic biopsy. The patient underwent a thoracoscopic left lower lobectomy. The histopathological and immunohistochemical examinations resulted in a diagnosis of alveolar adenoma. We report this case to describe its morphological and immunohistochemical characteristics and to emphasize its diagnostic difficulties.
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...
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.
Pathologica
Alveolar adenoma is a rare tumour of the lung. It is typically found in asymptomatic adults as a peripheral or subplerual nodule on imaging examination. Microscopically, the tumour is composed of admixture of epithelial and mesenchymal component in variable sized cystic or alveolar structures. The tumour shows a benign nature. There have been no reported recurrences or metastases. Malignant transformation of alveolar adenoma and coexisting with lung carcinoma have been rarely described. In this article, we report a case of an alveolar adenoma and coexisting atypical adenomatous hyperplasia. This case, contributing to the limited numbers of cases described to date, illustrates the importance of awareness on the possibility of alveolar adenoma being associated with lung carcinoma and its precursor lesions especially when diagnosed by small biopsy specimens.
Massive Relief: Papillary Adenoma of the Lung in Asymptomatic Former Smoker Patient
Diagnostics
Benign epithelial tumors of the lung are uncommon and can represent a diagnostic challenge. Herein, we describe one such emblematic case. A 59-year-old former smoker male was admitted to the hospital complaining of cough for a long time. A radiological examination showed a centrally excavated mass strictly connected to the visceral pleura. The patient underwent tumorectomy. At gross examination, the tumor was composed of solid and cystic areas containing clear liquid. Histological examination highlighted a sub-pleural encapsulated tumor, with foci of capsular invasion, characterized by a single layer of columnar and cuboidal epithelial cells lining moderately cellular fibro-vascular cores. A wide spectrum of immunohistochemical markers was performed. The final diagnosis was suggestive of a peripheral pulmonary papillary tumor of undetermined malignant potential. At the last follow-up, six years after surgery, no recurrence or metastases were described. Reporting this case, we would ...
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.
Small cell and squamous cell lung carcinomas: sequential occurrence at a single site
Thorax, 1987
The detection of a second primary bronchogenic carcinoma after treatment for small cell lung carcinoma is a rare' and recently described2 phenomenon. Nonetheless, at least 17 cases have been reported to date1 34 and there is now evidence to suggest that such tumours are an important late complication of small cell lung carcinoma in remission.4 In the present case the two tumours developed at the same site. To our knowledge this has not been reported before.