An unusual case of a microscopic alveolar adenoma coexisting with lung carcinoma: a case report and review of the literature

Abstract

IntroductionAlveolar 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.Case presentationA 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.ConclusionsWe 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.

Alveolar adenoma combined with multifocal cysts: Case report and literature review

“…3 Bronchoscopy is unlikely to be useful in this condition: no diagnosis of alveolar adenoma has been established using this method, owing to the subpleural location of the lesions. 19 Alveolar adenoma is also difficult to diagnose on small biopsy specimens and frozen sections as the tissue can appear similar to normal lung parenchyma, or in some cases can simulate a malignancy, with small glandular spaces lined by regular glandular epithelium. 4 Although cytology can be useful to exclude malignancy, it is difficult to recognize the specific type of benign lesions.…”

Alveolar Adenoma Resected by Thoracoscopic Surgery

“…[1][2][3][4][5] It is usually found in asymptomatic patients incidentally. The age range of patients is 34 to 74 years, occur in females more often than in males, the female to male ratio is 2:1.…”

“…1) A few iconographic studies have been conducted and the findings showed these lesions have characteristics consistent with benign nodules, but nonspecific. well-defined solitary nodule in the peripheral lung with an average size of 4.5 cm in diameter (0.6-9.8 cm) according to English medical literatures, 1,3,4) but sometimes alveolar adenoma coexists with lung carcinoma. 4) The clinical pathologic characteristics include the growth of type 2 alveolar epithelial cells with no signs of malignance.…”

“…well-defined solitary nodule in the peripheral lung with an average size of 4.5 cm in diameter (0.6-9.8 cm) according to English medical literatures, 1,3,4) but sometimes alveolar adenoma coexists with lung carcinoma. 4) The clinical pathologic characteristics include the growth of type 2 alveolar epithelial cells with no signs of malignance. 1) It is difficult to make a correct preoperative or intraoperative diagnosis, but can be confirmed after a resection based on its unique histopathologic characteristics.…”

Coexistence of lung alveolar adenoma with cerebral arteriovenous malformations: A case report and literature review

“…These pulmonary lesions are considered to be benign tumors and primarily occur in middle-aged woman who have no history of smoking. The size of these lesions usually varies, typically ranging between 0.2 and 10 cm (7,8).…”