Adenoid cystic carcinoma of the tracheobronchial tree: Clinicopathology and immunohistochemistry

Abstract

Adenoid cystic carcinoma of the tracheobronchial tree in five patients was treated surgically and the clinicopathologic manifestations and histogenesis were examined in detail. Symptoms such as cough, dyspnea, hemoptysis, and atelectasis on chest X-ray were present in four patients, and the other patient was asymptomatic. Histologically, growth patterns were classified as tubular, cribriform, and solid. The solid pattern was the most aggressive with extensive perineural invasion. Immunohistochemically, secretory component, lactoferrin, and epithelial membrane antigen were present in the cells lining the gland-like lumen of tissues with the tubular and cribriform patterns, but was rare in those with a solid pattern. Desmin and S-100 protein were detected in the nonlining cells of tissues with all three patterns. These findings suggest that this tumor originates from the myoepithelial cells of the bronchial gland and that the solid pattern was the most poorly differentiated form.

Primary adenoid cystic carcinoma of the lung: A clinicopathologic study

“…Some authors believe that histologic features (e.g., pattern of growth, cytologic atypia and mitotic activity) correlate with clinical behaviour of the lesions 10 . They highlighted that a predominantly tubular growth of ACC has a better prognosis than a tumour showing more solid growth pattern 10,11 . Others support the observation that clinical staging (e.g., size of tumours, extent of spread and metastases) at the time of initial diagnosis may be most important predictor of prognosis of this tumour 9, 12 .…”

Persistent Massive Hydropneumothorax in a Young Woman With Pulmonary Adenoid Cystic Carcinoma

“…3 Many patients with bronchopulmonary ACC present with wheezing and stridor because of the obstructing nature of the lesion and are often initially misdiagnosed with asthma, as was the case with our patient. 3,4 Primary lung malignancy is rarely associated with pneumothorax; most studies report that pneumothorax occurs in less than 1% of patients with primary lung malignancies. However, for patients with endobronchial malignancy, the frequency of pneumothorax is higher.…”

Adenoid Cystic Carcinoma of the Lung

“…2,3,5,11 Depending on the tumor location, bronchial narrowing with wall thickening may be seen, or peripheral lung nodules may be observed. 6 In contrast, in a minority of patients, there may be no detectable radiographic abnormality.…”

“…6 In contrast, in a minority of patients, there may be no detectable radiographic abnormality. 2,3,8,11 Endoscopically, ACCL is most frequently characterized as a broad-based polypoid endobronchial mass, showing varying degrees of bronchial obstruction and mucosal friability. In most studies, the radiographic and endoscopic appearance of ACCL was not sufficiently different from other types of lung tumors to permit distinction.…”

“…Affected patients are usually adults, with one study reporting patients ranging in age from 29 to 79 years (mean, 54 years), and with a fairly equal occurrence in men and women. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Adenoid cystic carcinoma of lung (ACCL) is usually centrally located in the trachea or proximal bronchi, and therefore patients typically present with signs and symptoms of bronchial obstruction or ulceration, including dyspnea, cough, wheezing, pneumonia, and/or hemoptysis. Peripherally located ACCL may be asymptomatic and is less common, 5,13 constituting only 10 to 15% of all ACCLs.…”