Pleomorphic adenoma of the bronchus

Pleomorphic adenoma of the trachea: A case report and review of the literature

BACKGROUND

Pleomorphic adenoma (PA) is the most common benign tumor that occurs in the salivary glands; however, tracheobronchial PA is rarely observed. To the best of our knowledge, fewer than 50 cases have been reported in the literature. We report a 49-year-old woman who had been treated for asthma for 2 years before being diagnosed with PA of the trachea.

CASE SUMMARY

A 49-year-old woman was referred to our hospital due to dyspnea upon exertion and chronic cough with wheezing for 2 years. Laboratory tests showed an elevated white blood cell count, absolute neutrophil count, and percentage of neutrophils. A chest computerized tomography scan showed a well-defined, soft-tissue density lesion measuring 2.4 cm × 2.1 cm in the lower trachea. Flexible bronchoscopy revealed that nearly 90% of the tracheal lumen was obstructed. The histopathological and immunohistochemistry features suggested PA of the trachea. Furthermore, we review the characteristics of 29 patients with tracheobronchial PA over the last 30 years.

CONCLUSION

Tracheobronchial PA occurs without gender predominance, mostly in the lower or upper trachea, and has a low recurrence rate. The median age at diagnosis is 48 years. The most common symptoms are cough, stridor, dyspnea, and wheezing.

Right main bronchial pleomorphic adenoma: A case report and literature review

RATIONALE

Tracheobronchial benign tumors are uncommon; particularly, bronchial pleomorphic adenoma is one of the rarest benign tumors that develop in bronchus (only 7 reported cases, among which only 4 cases of pleomorphic adenoma were seen arising from right main bronchus).

PATIENT CONCERNS

In this report, a 38-year-old woman suffered from progressive shortness of breath for 5 years due to right main bronchial pleomorphic adenoma.

DIAGNOSES

The patient was diagnosed as right main bronchial pleomorphic adenoma based on chest computed tomography enhanced scan, bronchoscopy, and histological examination.

INTERVENTIONS

An electrosurgical snare was performed to resect the neoplasm and several APC were administered at the sites of the resection to provide hemostasis and further coagulate for the residual neoplasm.

OUTCOMES

The patient was free of symptoms and the lumen of right main bronchus was clear during the follow-up period for 10 months without any procedure-related complications.

LESSONS

Bronchial pleomorphic adenoma is extremely rare, however, we should take it into consideration if a patient suffered from shortness of breath without an exact cause.

Pleomorphic adenoma of the main bronchus in an adult treated using a wedge bronchiectomy

A 34-year-old woman had complained of dyspnea on exertion for 3 months and was found to have a volume loss of the left lung. A smooth, vascularized, whitish nodular mass obstructing the orifice of the left main bronchus was noted on bronchoscopy. We performed a deep wedge resection of the main bronchus, preserving the lung parenchyma. Histopathologically, the tumor specimen was compatible with pleomorphic adenoma. To our knowledge, only two cases of pleomorphic adenoma arising from the main bronchus have been reported in the English-language literature, and ours is the first report of lung-preserving surgery.

A rare case of primary pleomorphic adenoma in main bronchus

Primary pleomorphic adenoma of the lung is a rare occurrence. Clinical suspicion is normally low due to its rarity. We describe a case of a primary pleomorphic adenoma arising from the origin of the right main bronchus and include our management strategy.

Epithelial and soft tissue tumors of the tracheobronchial tree

This article provides a broad overview of tumors that can involve the tracheobronchial tree. For the most part, the clinical, radiographic, and endoscopic presentation of these rare tumors does not differ significantly from the more common tumors of the lung. Appropriate classification of many tracheobronchial tumors ultimately requires complete sampling and a thorough microscopic evaluation. The introduction of ancillary diagnostic techniques such as immunohistochemistry and molecular analysis will continue to refine tumor classification.

Lipomatous mixed tumour of the skin: a histological, immunohistochemical and ultrastructural study

BACKGROUND

Mixed tumours are composed of an admixture of an epithelial/myoepithelial and usually a myxochondroid stromal component. Adipocytes are found more rarely, and account for a minor part of the tumour. To date, only three cases of mixed tumour/pleomorphic adenoma of the salivary gland have been described, showing an extensive adipocyte content of more than 90% of the tumour tissue. Owing to this peculiarity, some authors have defined it as 'lipomatous pleomorphic adenoma'. We are not aware of previously reported similar lesions in the skin.

OBJECTIVES

We report a case of a tumour that occurred as a 2 x 2 x 1.5 cm nodule in the scalp of a 65-year-old man. Analogies with salivary lipomatous pleomorphic adenoma, as well as histogenesis and differential diagnoses are discussed here.

METHODS

A histological, immunohistochemical and ultrastructural study was performed.

RESULTS

The tumour was well-circumscribed and showed a substantial mature adipose tissue component intermingled with epithelial cells arranged in ducts and branching tubules, embedded in a fibromyxoid stroma, which was diagnostic of a chondroid syringoma/mixed tumour. Adipocytes strongly expressed S-100 protein and cytokeratin 14. Transitional elements from epithelial/myoepithelial cells into adipocytes were observed. They coexpressed cytokeratin 14, S-100 protein and vimentin, and showed lipid droplets, desmosome-type junctions, cytoplasmic tonofilaments and basal lamina.

CONCLUSIONS

The tumour differed from lipomas with myxoid stroma and from lipoadenomas, which show non-proliferating normal sweat glands admixed with adipose tissue. Because of the similarity to lipomatous pleomorphic adenoma/mixed tumour of salivary glands, we suggest that it should be called 'lipomatous mixed tumour of the skin'.