Pulmonary Oncocytoma

Pulmonary oncocytomas are rare tumours with characteristic microscopic features.

Histologically, the tumour is composed of a diffuse proliferation of large polygonal cells with an abundant, granular cytoplasm, and round to irregular nuclei with prominent nucleoli.

Smaller eosinophilic cells with hyperchromatic nuclei and larger vacuolated cells are also observed in some cases.

Visit: Lung Tumour-Online ; Salivary gland-type tumours of Lung.

Reports suggest that no mucin production was detected and there were neither argyrophilic nor argentaffin cells, and no serotonin-positive cells.

Immunohistochemically, the tumour cells were positive for cytokeratins, vimentin and antimitochondrial antigen, whereas alpha-actin, chromogranin, synaptophysin, S-100 protein, and HMB-45 were negative.

According to one study on electron microscopy, abundant microvilli , have been described in pulmonary oncocytomas. Occasional, desmosomes and myelin figures as well as numerous mitochondria were also seen. No neurosecretory granules were present. Based on the findings the authors suggested that the tumor might have an epithelial origin from the bronchial serous gland with subsequent cellular degeneration.

Pulmonary Oncocytoma: A Rare Case.Asian Cardiovasc Thorac Ann. 2006 Dec;14(6):e113-e114.

Oncocytomas are rare tumors with characteristic histological features of large eosinophilic cells with prominent nucleoli and small round nuclei. They commonly occur in the kidney and salivary glands. Their occurrence in the lungs is very rare; fewer than 6 cases being reported so far in the available world literature. We encountered one such case and present the details of the management and its outcome.

Cytopathology of oncocytic carcinoid tumor of the lung mimicking granular cell tumor. A case report.Acta Cytol. 2000 Mar-Apr;44(2):247-50.

BACKGROUND: The cytopathologic features of oncocytic carcinoid tumor of the lung, a rare variant of carcinoid tumor that is composed exclusively of oncocytes, have not been described before in detail. CASE: The bronchial brush smears from an 80-year-old female with an endobronchial obstructive tumor showed single and loose clusters of tumor cells with abundant granular, eosinophilic cytoplasm. The differential diagnoses included oncocytic carcinoid tumor, granular cell tumor, other oncocytic tumors of bronchial origin and metastatic oncocytic tumors. Immunocytochemistry and electron microscopy confirmed the diagnosis of oncocytic carcinoid tumor. CONCLUSION: Oncocytic carcinoid tumor of the lung has cytopathologic features similar to those of granular cell tumor and pulmonary oncocytoma. Immunocytochemistry, electron microscope or both are necessary to distinguish these neoplasms.

Oxyphilic proliferations of the respiratory tract and paranasal sinuses.Semin Diagn Pathol. 1999 May;16(2):105-16.

Neoplasms of the upper respiratory comprised primarily of eosinophilic cells are, in general, rare, and they include a diverse group of lesions. Low-grade oncocytic neuroendocrine neoplasms (so-called oncocytic carcinoids) can be encountered in several locations throughout the respiratory tract. The oncocytoma and related entities, lesions that presumably arise from minor gland tissue, can likewise be seen from the nasal cavity to the lung; differences in clinical significance may relate to the location of such lesions, and are discussed herein. Granular cell tumor is another entity that can involve both the upper respiratory tract and lungs, and specific features of this lesion in different anatomic sites are highlighted. The oncocytic variant of Schneiderian papilloma is an important nasal lesion to recognize, because of important therapeutic and prognostic implications of that diagnosis. Finally, unique oncocytic variants of glomus tumor and pulmonary alveolar adenoma are discussed, as well as eosinophilic varieties of pulmonary carcinomas and mesotheliomas.

Multicentric oncocytoma of the lung diagnosed by fine-needle aspiration.Diagn Cytopathol. 1999 Jul;21(1):51-4.

A 50-yr-old man presented with dyspnea. On chest X-ray, multiple pulmonary nodules were observed. Fine-needle aspiration biopsy (FNAB) showed tridimensional aggregates of atypical round epithelial cells, containing numerous cytoplasmic granules. The tissue fragment confirmed the presence of an epithelial tumor composed of trabecular sheets of clear cells, with numerous cytoplasmic granules which stained with phosphotungstic acid hematoxylin (PTAH). Immunohistochemically, the tumor cells were positive for cytokeratins and antimitochondrial antigen, whereas chromogranin, synaptophysin, S-100 protein, and HMB-45 were negative. Clinical and tomographic studies ruled out any tumor mass elsewhere. The rarity of this lesion in the lung and the potential difficulties for its diagnosis prompted us to report the clinical, cytological, and immunohistochemical findings in this case.

Pulmonary oncocytoma: report of a case in conjunction with an immunohistochemical and ultrastructural study.Pathol Int. 1995 Jun;45(6) : 448-51

An intra-pulmonary mass in a 51 year old Japanese woman was incidentally discovered in the right middle lobe. The resected tumor was grossly well-demarcated, solid, light yellowish white in color and measured 3.0 x 2.0 x 1.5 cm in size. It was composed of a diffuse proliferation of large polygonal cells with an abundant, granular cytoplasm, and round to irregular nuclei with prominent nucleoli. Smaller eosinophilic cells with hyperchromatic nuclei and larger vacuolated cells were also observed. However, no mucin production was detected. There were neither argyrophilic nor argentaffin cells, and no serotonin-positive cells. They showed an immunoreactivity to cytokeratin and vimentin but not to alpha-actin. On electron microscopy, abundant microvilli, which have never been previously described in pulmonary oncocytomas, were observed. Occasional desmosomes and myelin figures as well as numerous mitochondria were also seen. No neurosecretory granules were present. These findings suggested that this tumor might have an epithelial origin from the bronchial serous gland with subsequent cellular degeneration.

Pulmonary oncocytoma.J Surg Oncol. 1985 Jul;29(3):173-5.

A pulmonary tumor composed of oncocytes was removed surgically from a 53-year-old man. Diagnosis was made after ultrastructural study. Pathological significance of this rare entity is briefly discussed and the literature reviewed.

Pulmonary oncocytoma. Report of a case with cytologic, histologic and electron microscopic study. Acta Cytol. 1985 Jul-Aug;29(4):620-3

The cytology of a pulmonary oncocytoma diagnosed by bronchial brushings is described along with the light and electron microscopic findings. Ultrastructurally, the tumor cells showed mitochondrial hyperplasia and an absence of neurosecretory granules. The possible histogenesis of pulmonary oncocytomas is discussed.

Oncocytoma of the lung: presentation of 1 case (author's transl) Chir Ital. 1980 Feb;32(1):103-7

The Authors describe one case of pulmonary oncocytoma successfully treated by ablative surgery. The patient was a man aged 38 with an asymptomatic nodule, about the size of a walnut, in his right lower lobe. The whole right lower lobe was removes surgically, and histological examination resulted i na diagnosis of pulmonary oncocytoma. In the discussion, the authors point out that this type of malignancy is extremely rare, with only 7 cases reported in the more recent literature to the best of their knowledge.