Department of Cardiac Intensive Care and Rehabilitation, Weifang People's Hospital, Shandong Province, China.
Department of Pathology, Weifang No. 2 People's Hospital, Shandong Province, China.
Medicine (Baltimore). 2023 Dec 15;102(50):e36559. doi: 10.1097/MD.0000000000036559.
To analyze the clinical-pathological characteristics of 3 cases of bronchiolar adenoma/pulmonary ciliary mucinous nodular papillary tumors, and to improve the understanding of bronchiolar adenoma (BA)/ciliated muconodular papillary tumors (CMPT) (bronchiolar adenoma/ciliated muconodular papillary tumor).
Retrospective analysis was done on the clinical information, diagnosis, and treatment of 3 instances of BA/CMPT at the Second People's Hospital of Weifang City. By scanning the CNKI, Wanfang, VIP database, and Pubmed database using the English key words "bronchiolar adenoma, ciliated muconodular papillary tumor," respectively patients with comprehensive clinical data were gathered, and studies from January 2002 to August 2021 that were relevant to the patients were examined.
A total of 35 articles and 71 instances were found, including 3 cases in our hospital, for a total of 74 cases. There were 31 males and 43 females among them, ranging in age from 18 to 84 years (average 63 years), and 15 cases had a smoking history. The majority of them were discovered by physical examination and had no clinical symptoms. The majority of the imaging revealed solid nodules with variable forms, with some ground-glass nodules displaying vacuole and bronchial inflation signs. BA/CMPT are generally gray-white, gray-brown solid nodules with obvious boundaries but no envelope with a maximum dimension of 4 to 45 mm (average 10.6 mm) on gross examination. Acinar, papillary, and lepidic formations can be seen under the microscope at high magnification; the majority of these structures are made up of tripartite epithelial components, including basal cells, mucous cells, ciliated columnar cells, and alveolar epithelial cells, demonstrating a variety of combinations. An important basis for diagnosis in immunohistochemistry is the continuous positive basal cell layer that is shown by p63, p40, and CK5/6. BRAF and epidermal growth factor receptor are the genes that are most frequently mutated. All of the patients showed no signs of metastasis or recurrence during follow-up period.
BA/CMPT is a rare benign tumor of lung epithelium. Because imaging and intraoperative cryosection diagnosis are easy to be misdiagnosed as malignant, it is necessary to further improve understanding and improve immunohistochemistry and genetic examination.
分析 3 例细支气管腺瘤/肺纤毛黏液结节乳头状肿瘤的临床病理特征，提高对细支气管腺瘤（BA）/纤毛黏液结节乳头状肿瘤（CMPT）（细支气管腺瘤/纤毛黏液结节乳头状肿瘤）的认识。
回顾性分析潍坊市第二人民医院 3 例 BA/CMPT 患者的临床资料、诊断及治疗情况。通过在中国知网、万方、维普数据库及 Pubmed 数据库中分别以英文关键词“bronchiolar adenoma，ciliated muconodular papillary tumor”检索，收集患者的综合临床资料，并查阅 2002 年 1 月至 2021 年 8 月的相关文献。
共检索到 35 篇文献及 71 例患者，包括我院 3 例，共计 74 例。其中男 31 例，女 43 例，年龄 1884 岁，平均 63 岁，15 例有吸烟史。多数患者因体检发现，无临床症状，影像学表现多数为形态各异的实性结节，部分呈磨玻璃结节，可见空泡及支气管充气征。BA/CMPT 大体呈灰白色、灰棕色实性结节，边界清楚，但无包膜，最大径 445mm，平均 10.6mm。镜下高倍放大可见腺样、乳头及贴壁样结构，多由三部分上皮成分构成，包括基底细胞、黏液细胞、纤毛柱状细胞及肺泡上皮细胞，多种组合形式存在。免疫组织化学中，p63、p40、CK5/6 连续阳性的基底细胞层是重要的诊断依据。BRAF、表皮生长因子受体基因突变最常见。所有患者随访期间均未见转移及复发征象。
BA/CMPT 是一种罕见的肺上皮良性肿瘤。由于影像学及术中冰冻切片诊断易误诊为恶性，有必要进一步提高认识，并完善免疫组织化学及基因检查。
