Epidemiology

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Physiology

• Benign mucoepithelial tumor of the lung
• Mucoepithelial tumors: rare tumors that arise from the mucous glands of the upper airway (trachea/ bronchi)/ oropharynx (tumor arising from salivary gland is named for that origin, but otherwise named as below)

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Pathology

• Cystic spaces within the tumor are lined by columnar cells
• Subtypes:
  • Pleomorphic bronchial adenoma: most common subtype to evolve into malignancy
  • Myoepithelioma:
  • Basal cell adenoma:
  • Adenolymphoma (Warthin tumor): occasionally develops squamous metaplasia or frank neoplasia
  • Oncocytic adenoma (Oncocytoma):
  • Canalicular adenoma:
  • Sebaceous adenoma:

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Clinical

• Endobronchial Nodule/Mass (see Obstructive Lung Disease, [[Obstructive Lung Disease]])
  • Diagnosis
    • FOB: usually occurs as sessile or polypoid mass in main or lobar bronchus
      • EBB: diagnostic
    • CXR/Chest CT: atelectasis, post-obstructive pneumonia
  • Clinical
    • Wheezing
    • Stridor
    • Cough
    • Post-Obstructive Pneumonia
• Lung Nodule (see Lung Nodule or Mass, [[Lung Nodule or Mass]])
• Dyspnea
• Hemoptysis (see Hemoptysis, [[Hemoptysis]]): may occur
• Fever/Weight loss: may occur
• Development of Higher Grade Malignancy within Bronchial Adenoma: most common with pleomorphic subtype

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Treatment

• Bronchoscopic Removal: fulguration/laser may be used for poor surgical candidates
• Surgical Excision ( with wide margins): usually recommended
  • Tumors may locally recur if not completely resected
• XRT: for positive surgical margins/ recurrent disease
  • Used more commonly with salivary gland origin, less experience with airway origin tumors
• Chemo: palliative (for metastatic disease)

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References

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