Alveolar adenoma with poor imaging: a case report

Abstract

Alveolar adenoma is an isolated, well-defined peripheral lung tumor that originates from type II alveolar cells. The tumor consists of a network of simple, low-cubic, epithelium-coated lacunae with varying amounts of fine and inconspicuous-to-thick spindle cells that sometimes contain mucus sample matrix. Few cases of alveolar adenoma have been reported. These tumors are usually detected by imaging examinations where the alveolar adenoma typically presents as a peripheral, solitary cystic nodule in the lung. The presentation may mimic that of other types of lung tumors, consequently leading to difficulties in the differential diagnosis of this condition. Thus, accurate diagnosis of alveolar adenoma is based on a combination of pathological sections and immunohistochemistry. This study describes an alveolar adenoma in a 59-year-old female patient. Chest X-ray imaging and chest computed tomography identified malignant lesions in the right upper lobe. The patient subsequently underwent a thoracoscopic right upper lobectomy. The diagnosis of alveolar adenoma was confirmed after pathological examination of the excised postoperative tissue. The disease course was stable, and there was no recurrence of pulmonary lesions during 3 years of postoperative patient follow-up. Herein, we report the case of a patient with benign alveolar adenoma with poor imaging and pathological results.

Alveolar adenoma: a rare benign tumour of the lung with a challenging diagnosis

“…In all reported cases, epithelial lining cells were positive for TTF-1, CK, surfactant apoprotein A, and Napsin A which confirms that the lining epithelial cells are type II pneumocytes, and they are negative for protein S100, and Ki67 (4,8).…”

“…The histogenesis of this tumour remains unknown. The majority of authors admit that type II pneumocytes are the origin of the epithelial component (4,5). Some authors, however, have proposed that the cell of origin in AA is probably a primitive mesenchymal cell differentiated toward a type II pneumocyte.…”

Alveolar Adenoma: A 20-Year Experience at a Western Balkan University Hospital and a Literature Review

“…Therefore, pathological examination may be the only confirmed method for a definitive diagnosis. 14 We found 6 case reports in the literature that used 18FDG-PET or 18FDG-PET/CT in the imaging evaluation of this lesion. Fluorodeoxyglucose (FDG) activity was not significant in 4 tumors, while in 2 tumors minor 18FDG avidity was reported.…”

“…4 Surgical methods were the best choice for both diagnosis and treatment. According to most cases from the literature, alveolar adenomas were treated video thoracoscopically, 2,4,10,11,14 but in some patients, thoracotomy was also performed. Usually, the reason for the thoracotomy was the anatomical localization of the tumor (central localization or the tumor was inseparable from a large blood vessel).…”

Pathological findings of pulmonary papillary adenoma with EGFR mutation and literature review: two cases report

“…Immunohistochemistry reveals P63-positive continuous basal layer cells, which can be distinguished from pulmonary papillary adenoma [ 9 ]. (4) Alveolar adenoma is a well-defined tumor, usually encapsulated, consisting of multiple cystic cavities mimicking alveolar cavities filled with eosinophilic granular material and lined with a single layer of type II alveolar cells, with characteristic spindle/inflammatory stroma and without papillary morphology [ 10 ]. (5) Pulmonary metastatic papillary thyroid carcinoma is clearly demarcated from surrounding tissues and may have a fibrous envelope.…”