Bronchial Adenomas & Carcinoid Tumors of Lung

• • 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

Imaging Findings

• • Chest film

  • Chest CT scan

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

  • Carcinoid syndrome rare with pulmonary tumors

• • Chest film

  • Chest CT

  • Bronchoscopy: Biopsy for tissue diagnosis; beware of bleeding

Surgery

• • 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

Medications

• • Chemotherapy indicated only for atypical carcinoid

Prognosis

• • Very good, in general

  • Lymph node and distant metastasis portend poor prognosis

References