Original articles

Bronchiolar adenoma: a clinic pathological analysis of 10 cases and review of literature

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  • 1. Department of Pathology, The Lu′an Hospital Affiliated to Anhui Medical University, Anhui Luan 237005, China
    2. Department of Pathology, The Lu′an People′s Hospital, Anhui Luan 237005, China

Received date: 2021-03-19

  Online published: 2022-06-28

Abstract

Objective: To study the clinic pathological characteristics, diagnosis and differential diagnosis of bronchiolar adenoma. Methods: Ten cases of bronchiolar adenoma in Lu′an people′s Hospital were collected from January to December 2020, and their clinical data, imaging results, histopathological features and immunohistochemical phenotype were analyzed with literature reviewed. Results: Of the patients, there were 4 males and 6 females, with age ranging from 49 to 79 years old. Most patients had no obvious clinical symptoms, and were found occasional pulmonary nodules by chest CT examination, with ground glass nodules on CT. All of the lesions were located in the periphery of the lung. Grossly, all of the tumors were well circumscribed, solid, and tan to brown on the cut surface. Six cases were the proximal type, and four case was the distal type. Microscopically, the tumor showed glandular, flat and papillary growth pattern, and a large amount of extracellular mucus could be seen. The lining cells of the cavity margin were mucous cells, ciliated cells, non-ciliated cuboidal cells and Clara cells. There was no atypia and mitosis. Continuous basal cell layer could be seen outside the cavity margin, and some tumors could be free of mucous cells and ciliated cells. Immunohistochemical staining of p40, p63 and CK5/6 showed the continuous basal cell layer. Conclusions: Bronchiolar adenoma is a kind of peripheral lung tumor composed of double-layer cells, the diagnosis requires the existence of a complete basal cell layer, and sometimes it is difficult to make a definite diagnosis. The existence of basal cell layer which is identified by immunological histochemistry (p40、p63 and CK5/6) is the key point for distinguish BA from lung adenocarcinoma.

Cite this article

LI Juan, LIU Jingsong, LI Mei, LI Dianwei, ZHU Hong . Bronchiolar adenoma: a clinic pathological analysis of 10 cases and review of literature[J]. Journal of Diagnostics Concepts & Practice, 2021 , 20(05) : 466 -470 . DOI: 10.16150/j.1671-2870.2021.05.008

References

[1] Chang JC, Montecalvo J, Borsu L, et al. Bronchiolar adenoma: expansion of the concept of ciliated muconodular papillary tumors with proposal for revised terminology based on morphologic, immunophenotypic, and genomic analysis of 25 cases[J]. Am J Surg Pathol, 2018,42(8):1010-1026.
[2] Ishikawa Y. Ciliated muconodular papillary tumor of the peripheral lung: benign or malignant?[J]. Pathol Clin Med, 2002,20:964-965.
[3] 王恩华. 细支气管腺瘤:易与癌混淆的良性肿瘤[J]. 中华病理学杂志, 2019,48(6):425-432.
[4] Sasaki E, Masago K, Fujita S, et al. AKT1 mutations in peripheral bronchiolar papilloma: glandular papilloma and mixed squamous cell and glandular papilloma is di-stinct from bronchiolar adenoma[J]. Am J Surg Pathol, 2021,45(1):119-126.
[5] 张杰, 邵晋晨, 韩昱晨, 等. 细支气管腺瘤病理诊断若干问题[J]. 中华病理学杂志, 2020,49(6):529-533.
[6] Jin Y, Shen X, Shen L, et al. Ciliated muconodular papillary tumor of the lung harboring ALK gene rearrangement: Case report and review of the literature[J]. Pathol Int, 2017,67(3):171-175.
[7] Shao K, Wang Y, Xue Q, et al. Clinicopathological features and prognosis of ciliated muconodular papillary tumor[J]. J Cardiothorac Surg, 2019,14(1):143.
[8] Liu L, Aesif SW, Kipp BR, et al. Ciliated muconodular papillary tumors of the lung can occur in western patients and show mutations in BRAF and AKT1[J]. Am J Surg Pathol, 2016,40(12):1631-1636.
[9] Liu S, Liu N, Xiao M, et al. First case of bronchiolar adenoma lined purely by mucinous luminal cells with molecu-lar analysis: a case report[J]. Medicine (Baltimore), 2020, 99(39):e22322.
[10] Sun Y, Liu M, Jiang Z, et al. Bronchiolar adenoma with diffuse pulmonary nodules: a extremely rare case report and review of literature[J]. BMC Pulm Med, 2020,20(1):192.
[11] Cao L, Wang Z, Gong T, et al. Discriminating between bronchiolar adenoma, adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung with CT[J]. Diagn Interv Imaging, 2020,101(12):831-837.
[12] Abe M, Osoegawa A, Miyawaki M, et al. Ciliated muco-nodular papillary tumor of the lung: a case report and li-terature review[J]. Gen Thorac Cardiovasc Surg, 2020,68(11):1344-1349.
[13] Tachibana M, Saito M, Kobayashi J, et al. Distal-type bronchiolar adenoma of the lung expressing p16 INK4a - morphologic, immunohistochemical, ultrastructural and genomic analysis - report of a case and review of the lite-rature[J]. Pathol Int, 2020,70(3):179-185.
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