Solitary Peripheral Ciliated Glandular Papillomas of the Lung

Abstract

We report 3 cases of solitary papillomas located in peripheral regions of the lung that are extremely rare in the literature. The patients were 75-year-old and 72-year-old men and a 53-year-old woman. One patient complained of recurrent hemoptysis. The other 2 had no symptoms, but abnormal nodular shadows were revealed by chest radiographs during a health check. The maximum diameters of the tumors were 1.0, 1.4, and 1.1 cm, respectively. The 3 tumors gave almost the same histologic findings. Papillomatous fronds lined by a stratified columnar epithelium were seen in the lumens of peripheral bronchi, bronchioles, or alveoli. The stratified columnar epithelium consisted of ciliated, mucous, and basal cells. The neoplastic epithelium extended to the alveolar region and showed a similar appearance to bronchioloalveolar or papillary type adenocarcinomas. For differential diagnosis, it is noteworthy that endobronchiolar papillomatous fronds constantly exist and spreading along alveolar walls is limited in adjacent alveoli in peripheral papillomas. The presence of ciliated cells and basal cells is considered an important finding to suggest benign character of the lesion.

Glandular papilloma of the lung with malignant transformation

“…The maximum value, 12.0%, was seen in the bronchiolar region of one case and the peripheral regions showed low values of 4.7%, 5.7%, and 2.3%, respectively [10]. The p53 labeling index was less than 10% in each of the three cases [10].…”

“…Miyoshi et al [14] noted YUJM VOLUME 34, NUMBER 2, DECEMBER 2017 a small number of positive cells for p53 and Ki-67 were scattered in mixed squamous cell and glandular papilloma. Aida et al [10] reported the Ki-67 labeling index ranged from 2.3% to 12.0% in their three cases of glandular papilloma. The maximum value, 12.0%, was seen in the bronchiolar region of one case and the peripheral regions showed low values of 4.7%, 5.7%, and 2.3%, respectively [10].…”

“…Aida et al [10] reported the Ki-67 labeling index ranged from 2.3% to 12.0% in their three cases of glandular papilloma. The maximum value, 12.0%, was seen in the bronchiolar region of one case and the peripheral regions showed low values of 4.7%, 5.7%, and 2.3%, respectively [10]. The p53 labeling index was less than 10% in each of the three cases [10].…”

“…Glandular papilloma make up about 20% of solitary pulmonary papillomas [4]. It appears predominantly in the central lobar or segmental bronchus [8,9], but few peripheral lesions also reported [4,10]. It arises on the mucosal surface, and range in size from 0.7 to 4 cm [2].…”

“…The columnar cells have eosinophilic cytoplasms and regular round nuclei. Cytologic or architectural atypia is not prominent [10], and mitosis and necrosis do not occur [10][11][12]. The fibrovascular cores often contain the infiltration of plasma cells.…”