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  • • Bronchial gland adenomas constitute 5% of all lung cancer

    • -Misnomer since vast majority actually malignant

    • Carcinoid lung tumors constitute 85% of bronchial adenomas

    • -Classified as typical or atypical

      -Derived from Kulchitsky cells

      -Located in central, proximal airways

      -Slow growing, can metastasize widely, rarely cause carcinoid syndrome

    • Adenoid cystic carcinoma (cylindromas)

    • -Locally aggressive, metastasis involve lung

      -Slow growing, amenable to resection

    • Mucoepidermoid cancer

    • -Rare tumors; mucus secreting cells and squamous cells present

      -Less aggressive

    • Mucous gland adenoma: Truly benign

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Imaging Findings

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  • • Chest film

    • Chest CT scan

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  • • May present as a solitary pulmonary nodule, and require work-up as such

    • Carcinoid syndrome rare with pulmonary tumors

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  • • Chest film

    • Chest CT

    Bronchoscopy: Biopsy for tissue diagnosis; beware of bleeding

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Surgery

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  • Surgery primary treatment: Lobectomy or sleeve

    Adenoid cystic carcinomas: Requires generous margins and frozen section exam at surgery

    • Up to 8 cm of trachea can be removed with primary anastomosis

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Medications

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  • • Chemotherapy indicated only for atypical carcinoid

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Prognosis

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  • • Very good, in general

    • Lymph node and distant metastasis portend poor prognosis

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References

Baaklini WA et al: Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest 2000;117:1049.  [PubMed: 10767238]
Gould MK et al: Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. JAMA 2001;285:914.  [PubMed: 11180735]

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