Bhavsar Tapan, Uppal Guldeep, Travaline John M, Gaughan Colleen, Huang Yajue, Khurana Jasvir S
Department of Pathology and Laboratory Medicine, Temple University Hospital, Philadelphia, PA, USA.
J Med Case Rep. 2011 May 18;5:187. doi: 10.1186/1752-1947-5-187.
Alveolar adenomas are extremely rare, benign, primary lung tumors of unknown histogenesis that are characterized by proliferative type II alveolar epithelium and septal mesenchyma. Mostly incidental, they are clinically important as they can imitate benign primary and secondary malignant tumors and at times are difficult to differentiate from early-stage lung cancer. We describe the case of a 59-year-old man with an incidental microscopic alveolar adenoma coexisting with poorly differentiated lung carcinoma.
A 59-year-old Caucasian man with a medical history of smoking and chronic obstructive pulmonary disease was incidentally found to have a right upper lobe mass while undergoing a computed tomographic chest scan as part of a chronic obstructive pulmonary disease clinical trial. Our patient underwent a right upper lobectomy after a bronchoscopic biopsy of the mass revealed the mass to be a carcinoma. A pathological examination revealed an incidental, small, 0.2 cm, well circumscribed lesion on the staple line margin of the lobectomy in addition to the carcinoma. Histopathological and immunohistochemical examinations revealed the lesion to be an alveolar adenoma.
We report the rare presentation of a microscopic alveolar adenoma coexisting with lung carcinoma. Alveolar adenoma is an entirely benign incidental neoplasm that can be precisely diagnosed using immunohistochemical analysis in addition to its unique histopathological characteristics.
肺泡腺瘤极为罕见，是一种组织发生不明的良性原发性肺肿瘤，其特征为增殖性II型肺泡上皮和间隔间充质。多数为偶然发现，临床上具有重要意义，因为它们可模仿良性原发性和继发性恶性肿瘤，有时难以与早期肺癌区分。我们描述了一例59岁男性病例，其偶然发现的微小肺泡腺瘤与低分化肺癌并存。
一名59岁有吸烟史和慢性阻塞性肺疾病病史的白种男性，在作为慢性阻塞性肺疾病临床试验一部分进行胸部计算机断层扫描时，偶然发现右上叶有一肿块。在对该肿块进行支气管镜活检显示为癌后，我们的患者接受了右上叶切除术。病理检查显示，除了癌之外，在叶切除术吻合钉切缘处偶然发现一个小的、0.2 cm、边界清晰的病变。组织病理学和免疫组织化学检查显示该病变为肺泡腺瘤。
我们报告了微小肺泡腺瘤与肺癌并存的罕见表现。肺泡腺瘤是一种完全良性的偶然肿瘤，除了其独特的组织病理学特征外，还可通过免疫组织化学分析进行精确诊断。
