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Primary pulmonary adenoid cystic carcinoma: report of a case diagnosed
by fine-needle aspiration cytology.Diagn
Cytopathol. 2004 Jan;30(1):51-6.
Adenoid cystic
carcinoma of the lower respiratory tract is an uncommon tumor that can
arise in the mainstem bronchus and often presents as an endobronchial
mass lesion causing bronchial obstruction with post obstructive
atelectasis and pneumonia. Exfoliative cytology is seldom useful in
the diagnosis of primary bronchial adenoid cystic carcinoma, because
these neoplasms usually have a submucosal location with often intact
mucosa. Since most endobronchial adenoid cystic carcinomas are
endoscopically visible, bronchoscope-guided fine-needle aspiration
constitutes an excellent approach to establish a pathologic diagnosis.
The fine-needle aspiration cytology of primary pulmonary adenoid
cystic carcinoma has been rarely described. We report a case of
primary adenoid cystic carcinoma of the lung having characteristic
cytologic features and correlate with computed tomography,
bronchoscopic, and histological findings. Bronchoscope-guided
aspiration cytology provided a conclusive diagnosis of adenoid cystic
carcinoma, which was further corroborated by histology in the
pneumonectomy specimen.
Adenoid cystic
carcinoma of lower lobe of right lung: report of a case.
Kyobu Geka. 2003 Oct;56(11):977-80.
A 69-year-old
male was admitted to the hospital for further examination of an
abnormal shadow in the right lower lung fields. He was previously
under medical treatment for right thoracic empyema. Chest computed
tomography (CT) showed a solitary mass, 4.5 cm in diameter and
broncofiberscopy evidenced a tumor in the right lower bronchus. The
biopsy was performed and the tumor was diagnosed as a pleomorphic
adenoma. Intraoperativefinding showed the tumor was 6 cm in gross,
extended to the left atrium, and a daughter tumor was palpable in the
middle lobe. The middle and lower lobe were resected. The tumor was
located in S9, S10, 6 x 4 x 3.5 cm in size, 2 daughter tumor was found
in the middle lobe, the pulmonary vein was thickened by tumor
invasion. Pathohistologically, main tumor and daughter tumor showed
malignant feature, were compatible with adenoid cystic cancer. Four
years after operation, he is still now alive with home oxygen therapy.
Primary peripheral
adenoid cystic carcinoma of the lung. A case report.
Acta Chir Belg. 2003 Aug;103(4):414-5.
We report a
rare case of peripheral adenoid cystic carcinoma of the lung, showing
unusual pathological and clinical features, namely rapid growth, local
aggressive behaviour, huge tumour size, no endobronchial component or
submucosal infiltration, and a rapidly progressive clinical course.
Extensive surgery resulted in considerable palliation of symptoms, but
not in prolonged survival. The reported case emphasizes the malignant
potential of peripheral adenoid cystic carcinoma of the lung.
Treatment outcome of
resected and nonresected primary adenoid cystic carcinoma of the lung.Ann
Thorac Cardiovasc Surg. 2002 Apr;8(2):74-7.
BACKGROUND AND
OBJECTIVE: The incidence of primary adenoid cystic carcinoma of the
lung is relatively rare and the optimal treatment strategy is still
unclear. METHODS: Sixteen adenoid cystic carcinoma patients were
treated at our institute from 1972 to 1998 and their clinical
features, treatments and survivals were reviewed. RESULTS: Half of all
patients were female and the median age was 46 ranging from 30 to 64.
All primary lesions were located in the central bronchial tree and 80%
of the patients had some symptoms. Eleven patients underwent a
resection of the tumor with/without plasty of the trachea or bronchus.
Although 6 (55%) of 11 patients had a microscopic residual tumor after
resection, 5 patients who received postoperative radiotherapy survived
without recurrence from 3 to 17 years. Five patients received
radiotherapy as their initial treatment and all tumors responded well
to the treatment. The 5-year and 10-year survival rates were 91 and
76% without local recurrence in the resected group and 40 and 0% in
the nonresected group, respectively. CONCLUSION: These observations
suggest that surgical resection should be selected first whenever
possible, and, in addition, adenoid cystic carcinoma is sensitive to
radiotherapy.
A case of adenoid cystic carcinoma of the left main
bronchus, which was performed carinal resection and reconstruction
while the aortic arch is pulled down.
Kyobu Geka. 2001
Jan;54(1):31-5.
A 55-year-old
woman, who had treated as bronchial asthma for eight months, was
admitted to our hospital. Chest CT scan showed a mass in the left main
bronchus. Bronchoscopic examination revealed a tumor obstructing the
left main bronchus and invading the left lower portion of the trachea.
The pathologic diagnosis was adenoid cystic carcinoma. Primary
resection of the left main bronchus and the carina with the objective
and one-stoma-type carinal reconstruction were performed by the left
thoracotomy. We pulled down the aortic arch to obtain an operative
field, and carried out the operative procedure at the upper side of
the aortic arch. As the resection margin contained residual tumor, the
postoperative irradiation (50 Gy) was added.
Primary
adenoid cystic carcinoma in the lung: report of two cases and
therapeutic considerations.
Lung Cancer.
1998 Mar;19(3):211-7.
Primary
adenoid cystic carcinoma in the lung is an uncommon disease, which is
regarded as a slow growing low-grade malignancy. However, this disease
has a high risk of incomplete resection because of its unique
histological invasion patterns. The cases of two patients who recently
underwent surgery for adenoid cystic carcinoma in the lung are
reported. Both patients received postoperative radiotherapy treatment
as a follow-up to a histologically incomplete resection. Both patients
have survived for 51 months and 7 months, respectively, with no
recurrence. Postoperative radiotherapy is an acceptable treatment of
choice to control residual lesions and provides long-term survival
even in cases of incomplete resection.
Adenoid cystic
carcinoma arising in the intrapulmonary bronchus.
Intern Med. 1996 May;35(5):407-9.
A 63-year-old
male was admitted to our hospital because of a coin lesion in the
intrapulmonary bronchus. The patient had no symptoms such as cough or
sputum. Imaging studies showed that the tumor was present in the
S10b,c of the right lung. There was no metastasis or salivary gland
tumor. Transbronchial tumor biopsy revealed a primary adenoid cystic
carcinoma. The patient underwent a lobectomy, and has been well since
the operation. This is an uncommon case of primary adenoid cystic
carcinoma arising from the intrapulmonary bronchus.
Adenoid cystic
carcinoma of the airway: thirty-two-year experience.
J
Thorac Cardiovasc Surg. 1996 Dec;112(6):1522-31; discussion
1531-2.
METHODS: We have
reviewed our experience in 38 patients with adenoid cystic carcinoma
of the upper airway seen between 1963 and 1995. The mean age was 44.8
years (15 to 80 years) with a male/female ratio of 1:1.1. Thirty-two
of the 38 patients were treated by resection and reconstruction
(primary anastomosis 28; Marlex mesh prosthesis 4). Twenty-six of the
32 patients undergoing resection received adjuvant radiotherapy. Six
patients with unresectable tumors were treated primarily with
radiotherapy only. RESULTS: Pathologic examination revealed local
invasion beyond the wall of the trachea in all patients. In a
majority, microscopic extension was found in submucosal and perineural
lymphatics, well beyond the grossly visible or palpable limits of the
tumor. Lymphatic metastases were relatively uncommon, occurring in
only five of 32 (19%) patients undergoing resection. Metachronous
hematogenous metastases occurred in 17 of 38 patients (44%). Thirteen
of these 38 patients (33%) had pulmonary metastases. Sixteen of 32
resections were complete and potentially curative. There were two
deaths within 30 days of operation. The mean survival in the 14
patients undergoing complete resection was 9.8 years (12 months to 29
years). Sixteen of 32 resections were incomplete (residual tumor at
the airway margin on final pathologic examination), with one operative
death occurring in this group. The mean survival in the 15 surviving
patients was 7.5 years (4 months to 21 years). Six patients were
treated with primary radiation only and had a mean survival of 6.2
years (2 months to 14.3 years). In the patients with pulmonary
metastases, mean survival was 37 months (4 months to 7 years) from the
time of diagnosis of the pulmonary metastasis until their death.
CONCLUSION: Adenoid cystic carcinoma of the upper airway is a rare
tumor, which is locally invasive and frequently amenable to resection.
Although late local recurrence after resection is a feature of this
tumor (up to 29 years), excellent long-term palliation is commonly
achieved after both complete and incomplete resection. There was a
small difference in survival between patients having complete and
incomplete resection. Long periods of control can be obtained with
radiotherapy alone. The best results, in this series of patients, were
obtained by resection. Adjuvant radiotherapy is assumed to favorably
influence survival.
Primary
adenoid cystic carcinoma of the lung. A clinicopathologic and
immunohistochemical study of 16 cases.
Cancer. 1994 Mar 1;73(5):1390-7.
BACKGROUND.
Adenoid cystic carcinoma (ACC) is a rare but distinctive salivary
gland-type malignant neoplasm that arises infrequently as a primary
tumor in the lung. METHODS. The clinical and pathologic features in 16
cases of primary ACC of the lung were reviewed, and
immunohistochemical stains on paraffin sections were performed in 7
cases. RESULTS. The patients' ages ranged from 29 to 79 years (mean
age, 54 years); 11 were men and 5 were women. Clinically, most
patients were seen initially with obstructive symptoms, including
cough, wheezing, shortness of breath, and hemoptysis. Eight tumors
were in the left lung and eight in the right lung. The lesions were
treated by pneumonectomy in seven patients, lobectomy in six, and
lobectomy plus chemotherapy in two. One patient was treated with
chemotherapy alone after undergoing a diagnostic biopsy that revealed
advanced disease. Grossly, most lesions were described as
endobronchial and measured from 0.9 to 4.0 cm in greatest dimension;
two cases, however, showed poorly circumscribed infiltrative tumors.
Histologically, three main growth patterns were identified admixed in
various proportions: cribriform (cylindromatous), tubular, and solid.
Immunohistochemical study in six of seven cases showed a prominent
myoepithelial cell component, as evidenced by immunoreactivity for
keratin, actin, and S-100 protein in numerous tumor cells. Clinical
follow-up ranging from 2 to 15 years in six patients showed that three
were alive and well without evidence of recurrence or metastases at 5,
10, and 12 years, respectively, and three were alive with recurrence
at 2, 5, and 15 years, respectively. Three other patients died of
unrelated conditions at 2, 7, and 9 years, respectively, after
diagnosis. Two patients in the study were seen initially with
metastatic spread at the time of initial diagnosis and died 2 months
and 1 year later with widespread metastases to lymph nodes, liver,
spleen, kidney, and bone despite intensive chemotherapy. CONCLUSIONS.
Disease stage at the time of diagnosis may play an important role in
predicting the clinical outcome of patients with these tumors. Despite
their generally slow and indolent growth in other locations, ACC
arising in the lung may in certain cases be more aggressive.
Bilateral multiple pulmonary coin lesions--adenoid
cystic carcinoma of the lung with 14-year follow-up.Pneumologie.
1994 Oct;48(10):769-71.
The authors
report on an adenoid cystic carcinoma (ACC) of the lung that had been
discovered by chance 14 years before the death of the patient and that
had at first been interpreted morphologically as a metastatic lung or
as a bronchioalveolar carcinoma. The patient remained without any
complaints for 13 years. Diagnosis of ACC became possible only by
means of a renewed peripheral lung biopsy. An extrapulmonary primary
tumour was excluded by postmortem examination. The disease pattern and
the special course of the ACC are described.
Peripheral
pulmonary adenoid cystic carcinoma with substantial submucosal
extension to the proximal bronchus.Thorax.
1991 Feb;46(2): 147-8.
A rare case of
a peripheral pulmonary adenoid cystic carcinoma is presented.
Histological examination after lobectomy showed pronounced submucosal
invasion of the carcinoma to proximal bronchi.
A case
of peripheral adenoid cystic carcinoma. Nihon
Kyobu Shikkan Gakkai Zasshi. 1990
May;28(5):773-6.
A case of
peripheral adenoid cystic carcinoma in a 70-year-old woman is
presented. She had a coin lesion in the left upper lung field on chest
X-ray film. Before one month on admission to our hospital, she noticed
a tumor in the left thigh and underwent simple resection. Histological
diagnosis was liposarcoma. Lung metastasis of the liposarcoma or
primary lung cancer were suspected. Lung wedge resection was performed
and adenoid cystic carcinoma was diagnosed. Generally adenoid cystic
carcinoma originates from bronchial gland, arising in the trachea or
main bronchus. In this case, the tumor originated from the peripheral
lung field.
Peripheral adenoid cystic carcinoma of the
lung.South
Med J. 1990 May;83(5):577-9.
The large peripheral lung mass found in a 63-year-old
female veteran proved to be adenoid cystic carcinoma of the lung.
These rare primary lung tumors should be distinguished from
adenocarcinoma, as the biologic activity and prognosis are much more
favorable.
Atypical manifestations of pulmonary adenoid cystic carcinoma.Br
J Dis Chest. 1986 Oct;80(4):396-9.
Pulmonary
adenoid cystic carcinoma (PACC) typically arises in large airways. A
patient who presented with a peripheral lung mass due to PACC is
reported. She was found to have multiple pulmonary nodules due to PACC
11 years after resection of the original tumour. We emphasize that
10-15% of patients with PACC present with peripheral tumours.
Adenoid cystic
carcinoma: a comparative pathologic study of tumors in salivary gland,
breast, lung, and cervix.Hum
Pathol.1982;13(10):916-24.
Histologic,
histochemical, and ultrastructural features of eight adenoid cystic
carcinomas arising at diverse sites were compared in order to
determine diagnostic values and to investigate histogenetic
mechanisms. These tumors originated in the salivary glands, breast,
uterine cervix, and tracheobronchial tree. By light microscopy each
tumor was seen to have morphologic features of adenoid cystic
carcinoma, yet only five of the eight cases showed differential
staining for the two mucin types, stromal and epithelial, which are
reportedly present in these tumors. In contrast, every case showed a
set of fine structural features which, in aggregate, are specific for
adenoid cystic carcinoma. These features include pseudocysts,
intercellular spaces, basal lamina, and true glandular lumens. The
most prominent feature is the pseudocyst, which mimics a glandular
lumen by light microscopy but is actually a rounded extracellular
space containing basal lamina. Ultrastructurally, the variation in
composition of the extracellular compartments, including pseudocysts
and true lumens, appears to explain the lack of uniformity in the
histochemical staining. The tumors also contained cytoplasmic
microfilaments in parallel bundles, consistent with myofilaments. The
presence of these filaments combined with basal lamina suggests
myoepithelial differentiation, yet it is not known whether these
tumors truly originate from myoepithelium or show differentiation
toward myoepithelium as a part of the neoplastic process. Regardless
of their histogenesis, this study shows that true adenoid cystic
carcinomas do arise in different organs. Knowledge of the specific
ultrastructural features of adenoid cystic carcinomas can be useful in
classifying these tumors in some cases.
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