Clinical and CT findings of 25 patients with bronchiolar adenoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Minghui ¹ , SUI Minghua ² , QIU Tiantian ¹ , SUN Xue ³ , TAN Xiao ³ ,  HOU Dailun ⁴

1. Department of Medical Imaging, Linyi People’s Hospital, Linyi, 276005, Shandong, P. R. China;
2. Department of Oncology, Yantai Yuhuangding Hosptial, Qingdao University, Yantai, 264000, Shandong, P. R. China;
3. Department of Pathology, Linyi People’s Hospital, Linyi, 276005, Shandong, P. R. China;
4. Department of Medical Imaging, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, P. R. China;

Corresponding author：

HOU Dailun, Email: hodelen@126.com

Keywords：

Bronchiolar adenoma; benign tumor; clinical feature; computed tomography; imaging feature

DOI：

10.7507/1007-4848.202210048

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Objective To study the clinical and CT findings of bronchiolar adenoma. Methods Patients diagnosed with bronchiolar adenoma confirmed by surgical pathology at Linyi People's Hospital and Yantai Yuhuangding Hospital from 2016 to 2021 were collected. Their clinical and CT imaging features were retrospectively analyzed. Results Finally, 25 patients were collected, including 6 males and 19 females, aged 32-73 (58.6±10.1) years. The immunohistochemical Ki-67 (MIB1) of all lesions was <5%. The lesions were located in the upper and middle lobe of both lungs in 9 patients, lower lobes in 16 patients, extrapulmonary zone in 22 patients, intrapulmonary middle zone in 3 patients, round in 11 patients, irregular in 14 patients, well-defined in 22 patients, pure ground-glass/mixed ground-glass nodules in 6 patients, solid nodules in 19 patients. There were 11 patients with central small cavity, 18 patients with single bronchioles sign, 19 patients without adhesion with adjacent pleura, and 24 patients without mediastinal lymph node enlargement. Conclusion Bronchiolar adenomas usually occur in the middle-aged and elderly, mostly in the lower lobe of both lungs and the distribution of the peripheral lung field, most of the patients do not have any clinical symptoms, and the postoperative prognosis is good. CT may show large nodules or masses, pure ground-glass/mixed ground-glass nodules, irregular solid nodules and central small cavities. Irregular stellate nodules, central small cavity shadow, and single bronchiolar vascular bundle connected with the lesions are relatively specific imaging findings of bronchiolar adenoma.

Citation： ZHANG Minghui, SUI Minghua, QIU Tiantian, SUN Xue, TAN Xiao, HOU Dailun. Clinical and CT findings of 25 patients with bronchiolar adenoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(8): 1127-1132. doi: 10.7507/1007-4848.202210048 Copy

1.	张杰, 邵晋晨, 韩昱晨, 等. 细支气管腺瘤病理诊断若干问题. 中华病理学杂志, 2020, 49(6): 529-533.Zhang J, Shao JC, Han YC, et al. Issues on pathological diagnosis of bronchiolar adenoma. Chin J Pathol, 2020, 49(6): 529-533.
2.	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. Am J Surg Pathol, 2018, 42(8): 1010-1026.
3.	Zheng Q, Luo R, Jin Y, et al. So-called "non-classic" ciliated muconodular papillary tumors: A comprehensive comparison of the clinicopathological and molecular features with classic ciliated muconodular papillary tumors. Hum Pathol, 2018, 82: 193-201.
4.	Nicholson AG, Tsao MS, Beasley MB, et al. The 2021 WHO classification of lung tumors: Impact of advances since 2015. J Thorac Oncol, 2022, 17(3): 362-387.
5.	Lu YW, Yeh YC. Ciliated muconodular papillary tumors of the lung. Arch Pathol Lab Med, 2019, 143(1): 135-139.
6.	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. Am J Surg Pathol, 2016, 40(12): 1631-1636.
7.	陈瑚, 黄建平, 冯昌银, 等. 细支气管腺瘤15例临床病理分析. 临床与实验病理学杂志, 2021, 37(10): 1224-1226.Chen H, Huang JP, Feng CY, et al. Bronchiolar adenoma: A clinicopathological analysis of fifteen cases. J Clin Exp Pathol, 2021, 37(10): 1224-1226.
8.	邱颍, 张乃春, 刘丽丽, 等. 肺细支气管腺瘤12例临床病理学观察. 中华病理学杂志, 2021, 50(8): 937-939.Qiu Y, Zhang NC, Liu LL, et al. Bronchiolar adenoma: A clinicopathological analysis of 12 cases. Chin J Pathol, 2021, 50(8): 937-939.
9.	高何, 杜晓刘, 陈春妮, 等. 细支气管腺瘤15例临床病理学观察. 中华病理学杂志, 2020, 49(6): 556-561.Gao H, Du XL, Chen CN, et al. Bronchiolar adenoma: A clinicopathological analysis of 15 cases. Chin J Pathol, 2020, 49(6): 556-561.
10.	Shao K, Wang Y, Xue Q, et al. Clinicopathological features and prognosis of ciliated muconodular papillary tumor. J Cardiothorac Surg, 2019, 14(1): 143.
11.	张明辉, 谭晓, 宋颖, 等. 肺纤毛黏液结节性乳头状瘤CT表现及临床病理特征分析. 中华肿瘤防治杂志, 2021, 28(11): 834-839.Zhang MH, Tan X, Song Y, et al. CT manifestations and clinical pathological characteristics analysis of pulmonary ciliary mucinous nodular papilloma. Chin J Cancer Prev Treat, 2021, 28(11): 834-839.
12.	Shirsat H, Zhou F, Chang JC, et al. Bronchiolar adenoma/pulmonary ciliated muconodular papillary tumor. Am J Clin Pathol, 2021, 155(6): 832-844.
13.	Guo Y, Shi Y, Tong J. Bronchiolar adenoma: A challenging diagnosis based on frozen sections. Pathol Int, 2020, 70(3): 186-188.
14.	Krishnamurthy K, Kochiyil J, Alghamdi S, et al. Bronchiolar adenomas (BA)—A detailed radio-pathologic analysis of six cases and review of literature. Ann Diagn Pathol, 2021, 55: 151837.
15.	赵静, 陆一凡, 俞士杰, 等. 细支气管腺瘤7例临床病理学分析. 诊断病理学杂志, 2022, 29(4): 336-339, 345.Zhao J, Lu YF, Yu SJ, et al. Bronchiolar adenoma: A clinicopathological analysis of seven cases. J Diag Pathol, 2022, 29(4): 336-339, 345.
16.	于丽丽, 吴建宇, 王伟, 等. 细支气管腺瘤临床病理特征及诊治分析. 浙江医学, 2022, 44(8): 841-845.Yu LL, Wu JY, Wang W, et al. Clinicopathological analysis of bronchiolar adenoma. Zhejiang Med, 2022, 44(8): 841-845.
17.	李娟, 刘劲松, 李梅, 等. 细支气管腺瘤10例临床病理分析及文献复习. 诊断学理论与实践, 2021, 20(5): 466-470.Li J, Liu JS, Li M, et al. Bronchiolar adenoma: A clinic pathological analysis of 10 cases and review of literature. J Diagn Concepts Pract, 2021, 20(5): 466-470.
18.	Abe M, Osoegawa A, Miyawaki M, et al. Ciliated muconodular papillary tumor of the lung: A case report and literature review. Gen Thorac Cardiovasc Surg, 2020, 68(11): 1344-1349.
19.	邓燕芳, 范明华, 谢丽卿, 等. 细支气管腺瘤临床、CT及病理学表现. 中国医学影像技术, 2022, 38(8): 1187-1191.Deng YF, Fan MH, Xie LQ, et al. Clinical, CT and pathological manifestations of bronchiolar adenoma. Chin Med Imaging Technol, 2022, 38(8): 1187-1191.
20.	Murakami K, Yutaka Y, Nakajima N, et al. Ciliated muconodular papillary tumor with a growing cavity shadow that mimicked colorectal metastasis to the lung: a case report. Surg Case Rep, 2020, 6(1): 231.
21.	李凤兰, 齐琳琳, 李琳, 等. 细支气管腺瘤的CT影像特征. 中华放射学杂志, 2022, 56(1): 62-67.Li FL, Qi LL, Li L, et al. CT imaging features of bronchiolar adenoma. Chin J Radiol, 2022, 56(1): 62-67.

1. 张杰, 邵晋晨, 韩昱晨, 等. 细支气管腺瘤病理诊断若干问题. 中华病理学杂志, 2020, 49(6): 529-533.Zhang J, Shao JC, Han YC, et al. Issues on pathological diagnosis of bronchiolar adenoma. Chin J Pathol, 2020, 49(6): 529-533.
2. 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. Am J Surg Pathol, 2018, 42(8): 1010-1026.
3. Zheng Q, Luo R, Jin Y, et al. So-called "non-classic" ciliated muconodular papillary tumors: A comprehensive comparison of the clinicopathological and molecular features with classic ciliated muconodular papillary tumors. Hum Pathol, 2018, 82: 193-201.
4. Nicholson AG, Tsao MS, Beasley MB, et al. The 2021 WHO classification of lung tumors: Impact of advances since 2015. J Thorac Oncol, 2022, 17(3): 362-387.
5. Lu YW, Yeh YC. Ciliated muconodular papillary tumors of the lung. Arch Pathol Lab Med, 2019, 143(1): 135-139.
6. 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. Am J Surg Pathol, 2016, 40(12): 1631-1636.
7. 陈瑚, 黄建平, 冯昌银, 等. 细支气管腺瘤15例临床病理分析. 临床与实验病理学杂志, 2021, 37(10): 1224-1226.Chen H, Huang JP, Feng CY, et al. Bronchiolar adenoma: A clinicopathological analysis of fifteen cases. J Clin Exp Pathol, 2021, 37(10): 1224-1226.
8. 邱颍, 张乃春, 刘丽丽, 等. 肺细支气管腺瘤12例临床病理学观察. 中华病理学杂志, 2021, 50(8): 937-939.Qiu Y, Zhang NC, Liu LL, et al. Bronchiolar adenoma: A clinicopathological analysis of 12 cases. Chin J Pathol, 2021, 50(8): 937-939.
9. 高何, 杜晓刘, 陈春妮, 等. 细支气管腺瘤15例临床病理学观察. 中华病理学杂志, 2020, 49(6): 556-561.Gao H, Du XL, Chen CN, et al. Bronchiolar adenoma: A clinicopathological analysis of 15 cases. Chin J Pathol, 2020, 49(6): 556-561.
10. Shao K, Wang Y, Xue Q, et al. Clinicopathological features and prognosis of ciliated muconodular papillary tumor. J Cardiothorac Surg, 2019, 14(1): 143.
11. 张明辉, 谭晓, 宋颖, 等. 肺纤毛黏液结节性乳头状瘤CT表现及临床病理特征分析. 中华肿瘤防治杂志, 2021, 28(11): 834-839.Zhang MH, Tan X, Song Y, et al. CT manifestations and clinical pathological characteristics analysis of pulmonary ciliary mucinous nodular papilloma. Chin J Cancer Prev Treat, 2021, 28(11): 834-839.
12. Shirsat H, Zhou F, Chang JC, et al. Bronchiolar adenoma/pulmonary ciliated muconodular papillary tumor. Am J Clin Pathol, 2021, 155(6): 832-844.
13. Guo Y, Shi Y, Tong J. Bronchiolar adenoma: A challenging diagnosis based on frozen sections. Pathol Int, 2020, 70(3): 186-188.
14. Krishnamurthy K, Kochiyil J, Alghamdi S, et al. Bronchiolar adenomas (BA)—A detailed radio-pathologic analysis of six cases and review of literature. Ann Diagn Pathol, 2021, 55: 151837.
15. 赵静, 陆一凡, 俞士杰, 等. 细支气管腺瘤7例临床病理学分析. 诊断病理学杂志, 2022, 29(4): 336-339, 345.Zhao J, Lu YF, Yu SJ, et al. Bronchiolar adenoma: A clinicopathological analysis of seven cases. J Diag Pathol, 2022, 29(4): 336-339, 345.
16. 于丽丽, 吴建宇, 王伟, 等. 细支气管腺瘤临床病理特征及诊治分析. 浙江医学, 2022, 44(8): 841-845.Yu LL, Wu JY, Wang W, et al. Clinicopathological analysis of bronchiolar adenoma. Zhejiang Med, 2022, 44(8): 841-845.
17. 李娟, 刘劲松, 李梅, 等. 细支气管腺瘤10例临床病理分析及文献复习. 诊断学理论与实践, 2021, 20(5): 466-470.Li J, Liu JS, Li M, et al. Bronchiolar adenoma: A clinic pathological analysis of 10 cases and review of literature. J Diagn Concepts Pract, 2021, 20(5): 466-470.
18. Abe M, Osoegawa A, Miyawaki M, et al. Ciliated muconodular papillary tumor of the lung: A case report and literature review. Gen Thorac Cardiovasc Surg, 2020, 68(11): 1344-1349.
19. 邓燕芳, 范明华, 谢丽卿, 等. 细支气管腺瘤临床、CT及病理学表现. 中国医学影像技术, 2022, 38(8): 1187-1191.Deng YF, Fan MH, Xie LQ, et al. Clinical, CT and pathological manifestations of bronchiolar adenoma. Chin Med Imaging Technol, 2022, 38(8): 1187-1191.
20. Murakami K, Yutaka Y, Nakajima N, et al. Ciliated muconodular papillary tumor with a growing cavity shadow that mimicked colorectal metastasis to the lung: a case report. Surg Case Rep, 2020, 6(1): 231.
21. 李凤兰, 齐琳琳, 李琳, 等. 细支气管腺瘤的CT影像特征. 中华放射学杂志, 2022, 56(1): 62-67.Li FL, Qi LL, Li L, et al. CT imaging features of bronchiolar adenoma. Chin J Radiol, 2022, 56(1): 62-67.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical and CT findings of 25 patients with bronchiolar adenoma

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