Mixed squamous cell and glandular papilloma of the lung resembling early adenocarcinoma: A case report

FDG PET/CT in a Case of Solitary Mixed Squamous Cell and Glandular Papilloma of the Lung With High CEA Level

ABSTRACT

Solitary mixed squamous cell and glandular papilloma of the lung is an extremely rare benign neoplasm. We describe FDG PET/CT findings in a case of solitary mixed squamous cell and glandular papilloma of the lung with high serum carcinoembryonic antigen level (63.3 ng/mL; reference, <5 ng/mL). The tumor showed intense FDG uptake with SUVmax of 23.8 mimicking lung cancer.

Endobronchial Glandular Papilloma With Atypical Histologic Characteristics: A Case Report and Literature Review

Papilloma of the lung is a rare benign entity and can be solitary or multiple. Solitary papilloma is subclassified into three categories: squamous papilloma, glandular papilloma, and mixed squamous and glandular papilloma. Glandular papilloma is the rarest subtype among them and occurs mostly in the sixth decade without any relation to smoking, syndrome, or infection. Histology is characterized by mixture of pseudostratified, columnar, nonciliated, mucinous epithelium-lined papillary fronds without any mitoses, necrosis, or atypia. The differential diagnosis can be broad depending upon the histologic features present in a particular case and may include both benign and malignant entities. We present here a patient with glandular endobronchial papilloma showing unusual clinical history and atypical histologic features, which required extensive immunohistochemical evaluation to establish a final diagnosis.

Mixed squamous cell and glandular papilloma of the lung increased in twelve years -A case report

We report the case of a 55-year-old man presented with a nodule in the right middle lung on computed tomography. The size of the nodule had increased at 12 years after the first visit. Consequently, the patient was diagnosed with a Mixed squamous cell and glandular papilloma (MSGP) by surgical resection. To our knowledge, there are no previous studies that MSGP in the lung which had been observed for 12 years before surgery. This study reports the case of a patient who underwent surgical resection of a MSGP.

Clinicopathological Analysis of Bronchiolar Adenoma Lined Purely by Mucinous Luminal Cells

Bronchiolar adenoma (BA) is a rare lung tumor that has recently been clearly named, including the previous ciliated muconodular papillary tumor (CMPT) and the so-called nonclassical CMPT. The most prominent histological feature of BA is a double-layer cell structure composed of a continuous basal cell layer and a luminal cell layer. BA lined purely by mucinous luminal cells is very rare, and only one case has been reported in the English literature. This type of BA can easily be misdiagnosed as early mucinous adenocarcinoma. This article analyzes the clinicopathological characteristics of a newly discovered case of BA lined purely by mucinous luminal cells and fully integrated with the literatures.

Pulmonary peripheral glandular papilloma and mixed squamous cell and glandular papilloma frequently harbour the BRAF V600E mutation

AIMS

Pulmonary peripheral glandular papilloma (GP) and mixed squamous cell and glandular papilloma (MP) have very similar histological features to pulmonary ciliated muconodular papillary tumour (CMPT)/bronchiolar adenoma (BA). The underlying genetic relationships between GP/MP and CMPT/BA have rarely been characterised. We aimed to reveal the relationship between them.

METHODS AND RESULTS

We performed a clinicopathological review and next-generation sequencing (NGS) study of two GPs and five MPs. Histologically, GPs/MPs showed similar cellular and architectural features to CMPTs/BAs, such as bilayered epithelium, bronchiole-associated lesions and skipping (discontinuous) growth pattern. One MP showed partial and inconspicuous endobronchiolar growth and more glandular structures, which was very similar to the appearance of CMPT/BA. BRAF V600E mutation was detected in four papillomas (57.1%, one GP and three MPs).

CONCLUSIONS

Overlapping morphological features and comparable mutation profiles support that peripheral GPs/MPs and CMPTs/BAs are on the same disease spectrum. We propose expanding the concept of CMPT/BA and including GP and MP in the CMPT/BA family.

Mixed squamous cell and glandular papilloma of the lung-A case report and literature review in Japan

INTRODUCTION

Mixed squamous cell and glandular papilloma (MSGP) of the lung is rare neoplasm, only 19 cases previously reported in Japan. MSGP is one of three separate categories of solitary endobronchial papillomas, which account for less than 0.5 % of all lung tumors. MSGP is rarest of the three. We present a rare case of MSGP and review the literature in Japan.

PRESENTATION OF CASE

A 49-year-old man presented with a nodulous shadow in the right lower lung field identified on a chest X-ray performed for back pain. Computed tomography demonstrated a well-circumscribed, 9-mm mass in the S8 segment of the right lower lung lobe. Positron emission tomography showed accumulation of 18F-fluorodeoxyglucose in the tumor with a standardized uptake value of 2.29. Following thoracoscopic partial resection, adenocarcinoma was diagnosed by frozen section, and radical segmentectomy of S8 was performed. The final diagnosis was mixed squamous cell and glandular papilloma. The patient had an uncomplicated postoperative course and remains asymptomatic 3 years after the procedure.

DISCUSSION

The etiology and pathological characteristics of MSGP remain unclear. There has been no report of recurrence in MSGP cases treated with complete resection; thus, limited resection that preserves pulmonary function is desirable. Further data including new cases are required.

CONCLUSION

We present a rare case of mixed squamous cell and glandular papilloma (MSGP) of the lung and review the literature in Japan. Limited resection that preserves pulmonary function, while ensuring complete resection, is desirable. Further investigations with new cases are required.

Histologic characteristics and prognosis of lung mixed squamous cell and glandular papilloma: six case reports

Lung mixed squamous cell and glandular papilloma (LMSCGP) has no clear signs, clinical symptoms, or imaging features; thus, its diagnosis primarily relies on post-resection histology and immunohistochemistry. Therefore, in this work six case reports are described to review the clinicopathologic characteristics, diagnosis, treatment, and prognosis. Here, we report the clinical symptoms, imaging features, pathologic characteristics, and follow-up data of six LMSCGP patients. Among the 6 patients, 4 were males and 2 were females, with a mean age of 52.7 years (39-67 years). These patients accounted for 0.0827% of patients who underwent thoracic surgery in the same period (6/7357). Preoperative diagnosis indicated cancer or most likely cancer in 3 patients, benign lesions in 3 patients, and bronchial adenoma in 1 patient. All 6 patients underwent surgery, consisting of wedge resection in 3 patients and lobectomy in the other 3 patients. Hilar lymph node metastasis was not identified during postoperative pathologic diagnosis. Conclusion: LMSCGP is a rare lung tumor with a certain heterogeneity that makes definite preoperative diagnosis difficult. Complete surgical resection is the preferred treatment choice and results in a good prognosis in most cases.

Ciliated muconodular papillary tumor of the lung harboring BRAF V600E mutation and p16INK4a overexpression without proliferative activity may represent an example of oncogene-induced senescence

Ciliated muconodular papillary tumor (CMPT) is a rare peripheral lung tumor that shows puzzling histologic features encompassing metaplastic and neoplastic nature. This type of tumor is occasionally misdiagnosed as lung adenocarcinoma clinically and pathologically, and its pathogenic mechanism has not been well characterized. We experienced a case of CMPT in a 73-year-old male and performed targeted deep sequencing to characterize its molecular features. The tumor was an ill-defined, subpleural, and non-endobronchial nodule showing glandular and papillary proliferation of mucous cells, ciliated columnar cells, and basal cells without any cytologic atypia. Abundant intra-alveolar mucin surrounded the main lesion. The patient was well without recurrence throughout 36 months of follow-up. Our case harbored BRAF V600E mutation and strongly expressed p16INK4a without proliferative activity, representing senescence and indolent biologic behavior. Overall, the results of this study indicate that BRAF V600E mutation might be the driver for tumorigenesis of CMPT and eventually leads to oncogene-induced senescence of this tumor.