Krifa Marwa, Bdioui Ahlem, Lajmi Zainab, Missaoui Nabiha, Hmissa Sihem, Mokni Moncef
Pathology Department, Farhet Hached University Hospital, 4000, Sousse, Tunisia.
Pathology Department, Sahloul University Hospital, 4002, Sousse, Tunisia.
Heliyon. 2021 Feb 5;7(2):e06206. doi: 10.1016/j.heliyon.2021.e06206. eCollection 2021 Feb.
Primary adenoid cystic carcinoma (ACC) of the lung is an unusual thoracic neoplasm with slow growing and low-grade malignancy. Usually, it is diagnosed at a higher clinical stage and is difficult to resect due to its central location. Herein, we report a 56-year-old man with hemoptysis associated with dyspnea and weight loss lasting for one month. Bronchial fibroscopy highlighted a budding nodular tumor in the left main bronchus. The patient underwent a left pneumonectomy with mediastinal lymphadenomectomy. Microscopic examination showed tumor cells infiltrating the bronchial wall and the cartilage and concluded to an ACC of the left bronchus. Ear, nose, and throat examination as well as cervico-facial magnetic resonance imaging were performed to search a primary salivary gland tumor and were returned without abnormalities. The tumor was classified as a primary ACC of the left bronchus without lymph node metastasis. To avoid their misdiagnosis, ACCs of the lung should be well known by the pathologist and surgeons. Their pathological features may be misleading and referring to a benign lesion, however, the presence of cribriform foci and infiltrative pattern are very suggestive. Although, indolent and slow growing tumor, long-term recurrences are quite frequent, especially in case of unclear surgical margin.
原发性肺腺样囊性癌（ACC）是一种不常见的胸部肿瘤，生长缓慢，恶性程度低。通常，它在较高临床分期时被诊断出来，由于其位于中央位置，难以切除。在此，我们报告一名56岁男性，咯血伴呼吸困难和体重减轻持续1个月。支气管纤维镜检查发现左主支气管有一个芽状结节性肿瘤。患者接受了左肺切除术及纵隔淋巴结清扫术。显微镜检查显示肿瘤细胞浸润支气管壁和软骨，诊断为左支气管ACC。进行了耳鼻喉检查以及头颈磁共振成像以寻找原发性涎腺肿瘤，结果均无异常。该肿瘤被分类为无淋巴结转移的左支气管原发性ACC。为避免误诊，病理学家和外科医生应充分了解肺ACC。其病理特征可能具有误导性，看似良性病变，但筛状病灶和浸润模式的存在极具提示性。尽管肿瘤生长缓慢且惰性，但长期复发相当常见，尤其是手术切缘不清晰的情况。
