Cardiothoracic Surgery: Bronchial Adenoma

Bronchial Adenoma

Types

  • Bronchopulmonary Carcinoid Tumor (90% – Most Common)
  • Salivary Gland Tumors (10%):
    • Adenoid Cystic Carcinoma (ACC)
      • Invades Nerve Roots & Can Spread by Perineural Lymphatics
    • Mucoepidermoid Carcinoma

Bronchopulmonary Carcinoid Tumor

  • *See Small Intestine: Carcinoid Tumor
  • Presentation:
    • Dyspnea
    • Wheezing
    • Cough
    • Hemoptysis
    • Carcinoid Syndrome (Diarrhea, Flushing, etc.)
    • May Secrete Ectopic ACTH (Cushing Syndrome)
  • Diagnosis:
    • Initial Imaging: CT
      • May Consider Somatostatin Receptor Scintigraphy (SRS) to Localize or Identify Metastatic Lesions
    • Diagnosis: Bronchoscopy with Biopsy
  • Treatment:
    • Primary Treatment: Surgical Resection

Salivary Gland Tumors

  • Arise from the Submucosal Glands of the Tracheobronchial Tree
  • Presentation:
    • Dyspnea
    • Wheezing
    • Cough
    • Hemoptysis
  • Diagnosis:
    • Initial Imaging: CT
    • Diagnosis: Bronchoscopy with Biopsy
  • Treatment:
    • Primary Treatment: Surgical Resection
    • Adjuvant Radiation Therapy for Adenoid Cystic Adenoma (Very Radiosensitive)

Bronchopulmonary Carcinoid Tumor on CT (A) and Bronchoscopy (B) 1

Bronchopulmonary Carcinoid Tumor on Resection 1

Bronchial Mucoepidermoid Carcinoma After Lobectomy 2

References

  1. Neuberger M, Hapfelmeier A, Schmidt M, Gesierich W, Reichenberger F, Morresi-Hauf A, Hatz RA, Lindner M. Carcinoid tumours of the lung and the ‘PEPPS’ approach: evaluation of preoperative bronchoscopic tumour debulking as preparation for subsequent parenchyma-sparing surgery. BMJ Open Respir Res. 2015 Jul 15;2(1):e000090. (License: CC BY-NC-4.0)
  2. Krishnamurthy A, Ramshankar V, Majhi U. Role of fluorine-18-fluorodeoxyglucose positron emission tomography-computed tomography in management of pulmonary mucoepidermoid carcinomas and review of literature. Indian J Nucl Med. 2016 Apr-Jun;31(2):128-30. (License: CC BY-NC-SA-3.0)