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Mucous gland adenomas are rare benign neoplasms believed to arise from minor salivary-type glands of the bronchi. They are usually solitary and their diagnosis is seldom made pre-operatively. Endoscopically, they appear as pink to white sessile polypoid structures with smooth glistening surfaces. Little is known about their radiographic appearance but on CT they have been described as well-demarcated...
Teratomas are neoplasms derived from two or more germ cell lines that may be either mature or immature. Teratomas occur in individuals aged 19–68 years old but some occur in younger individuals. The presenting symptoms are those of an intrapulmonary mass. Rarely, trichoptysis (literally, the expectoration of hair) has been described in some cases. Teratomas are slow-growing tumors, and slow growth...
Chondromas are tumors of the lung and the airways which are made entirely of benign cartilage and by definition, lacking entirely of fat, muscle, or bone. Their true frequency is not known since hamartomas with major cartilaginous components are likely to have been misclassified in the past as chondromas. In addition to the lung, they occur in the larynx, trachea, and major bronchi. Primary chondrosarcomas...
Under the name “Uncommon Endobronchial Surface Tumors,” we consider generally benign epithelial proliferations of the trachea and bronchi whose common denominator is a papillary growth pattern. Currently, the World Health Organization recognizes three major histopathologic types: squamous, glandular, and mixed-type papillomas.
This uncommon non-small cell variant of lung cancer is characterized by combined histopathologic features of squamous cell carcinoma and adenocarcinoma. Most patients have history of smoking and the clinical presentation is similar to that of other non-small cell carcinomas. A requirement for diagnosis is that each component represents at least 10% of the tumor substance. Furthermore, unequivocal...
This is a rare neoplasm believed to arise from ectopic or aberrant thymic tissue in either lung or pleura, with histologic features resembling those of thymomas occurring in the thymus gland. The clinical manifestations are nonspecific including cough, chest pain, and fever. Tumors located near the pleura may be associated with effusions. Rare cases associated with myasthenia gravis have been reported...
Currently, adenocarcinoma ranks as the number one type of major lung cancer, constituting a significant proportion of all of the non-small cell lung cancers. In contrast to small cell and squamous cell lung cancers which are centrally located, most adenocarcinomas are peripheral, subpleural in location. The few that are central may be visualized endoscopically as endobronchial polyoid masses. Radiographically,...
Langerhans cell histiocytosis (LCH) formerly known as pulmonary eosinophilic granuloma is currently regarded by the World Health Organization as a clonal neoplastic proliferation of histiocytes. However, adult variants may represent reactive processes, usually associated with cigarette smoking. Most patients with LCH are either current or former smokers. Radiographically, LCH shows a predilection...
This carcinoma represents about 10% of all lung cancers. Microscopically, its main feature is the high level of malignancy and lack of squamous or glandular features. However, on electron microscopy, features of either adenocarcinoma or squamous cell can be appreciated suggesting that large cell carcinomas are basically poorly differentiated adenocarcinomas or squamous cell carcinomas. Nonetheless,...
This type of pulmonary vascular tumor differs primarily from epithelioid hemangioendothelioma and angiosarcoma on account of its intravascular location and fibroblastic or leiomyomatous nature. Clinically, pulmonary artery sarcoma may present as a single large pulmonary embolus or multiple smaller emboli. Some may present with symptoms and signs right sided cardiac failure. CT tomography, MRI and...
A major type of non-small cell lung cancer, squamous cell carcinoma was for many years the leading cell type in terms of frequency. Currently, it ranks second to adenocarcinoma but remains a major cause of morbidity and mortality. As is the case with small cell cancers, squamous cell carcinomas are centrally located, near the hilum and prone to present with hemoptysis and/or early symptoms related...
A low-grade lymphoma, maltoma, represents a form of marginal zone lymphoma arising from mucosal (bronchial) associated lymphoid tissue. Maltomas may arise de novo or be preceded by autoimmune disorders of the lung. Radiographically, maltoma may present as single or multiple nodular masses involving one or both lungs. Airways are usually not affected by these tumors and are likely to remain intact,...
Small cell carcinomas are highly malignant tumors composed of relatively small uniform cells with scant cytoplasm and stippled nuclear chromatin pattern. An ultrastructural hallmark of these tumors is the presence of membrane-bound, electron-dense granules that contain a variety of active peptide moieties. Small cell carcinomas occur in middle age and older individuals with a mean age of 59 years...
Hamartomas are benign mesenchymal neoplasms containing tissues made up of cartilage, smooth muscle, and connective tissue. They occur in the trachea, bronchi, and the lung parenchymal tissues and are said to be the most common benign tumors of the lung. Hamartomas, particularly the intraparenchymal variants, are clinically silent in the majority of cases. However, the endobronchial ones present with...
Pleomorphic adenomas are benign neoplasms with mixed epithelial and mesenchymal components that may be endobronchial or parenchymal. They are derived from seromucinous glands of the airway and are similar to those seen in major salivary glands. These tumors are more frequent in men by a factor of about 2:1 with a mean age of 50 years. Productive cough and intermittent dyspnea are manifestations of...
Primary melanomas of the lung are rare malignant tumors of uncertain histogenesis believed by some to arise from melanocytic metaplasia of the bronchial respiratory epithelium or from primitive displaced melanocytic cells from the foregut, during the process of embryogenesis. Melanomas show no gender predilection and most occur between the ages of 29 and 80 years. Clinical symptoms are related to...
This unique subtype of adenocarcinoma is primarily characterized by its distinctive architectural growth pattern. In this type of growth pattern, called lepidic pattern, the tumor cells spread along intact pre-existing alveolar walls. Mucinous, non-mucinous, and mixed variants are recognized. In addition to this architectural growth pattern, demonstration of vascular, pleural or stromal invasion is...
A highly distinctive malignant tumor arising from tracheobronchial glands, adenoid cystic carcinoma is characterized by tubular, cribriform, and solid histopathologic patterns and a propensity for extension along perineural spaces. Asthma-like manifestations with wheezing as a prominent sign can be seen in proximally located lesions. Ulceration of the overlying mucosa may result in blood-tinged sputum...
Under the category of benign adenomas of the lung, the current World Health Organization classification of Tumors recognizes mucous gland adenoma, mucinous cystadenoma, pleomorphic adenoma, alveolar adenoma, and papillary adenoma. Here we discuss only alveolar adenomas. Alveolar adenomas are rare, benign usually solitary, peripherally located proliferations made of a network of cystic spaces lined...
The high-grade non-Hodgkin lymphoma is characterized by a diffuse proliferation of large neoplastic B cells, typically showing nuclear size equal to or greater than the size of a normal macrophage. It is the second most common pulmonary lymphoma after maltoma. It occurs in a wide age range from children to adults. Patients are usually symptomatic. Grossly, the lesions are nodular in configuration...
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