Despite the fact that the term 'bronchial adenoma' suggests a non-neoplastic disease, it really stands for a multitude of tumor types, originating from the bronchial glands or epithelium, like carcinoid, adenoid cystic carcinoma, mucoepidermoid carcinoma or mucous gland adenoma. These neoplasms have a more or less prominent malignant potential that dictates clinical evolution.
Bronchial adenoma may be asymptomatic, especially if located in a distal area. In these cases, they are discovered incidentally. When the disease does induce clinical manifestations, these may mimic other conditions, like asthma or pneumonia. Symptoms like a cough (dry or productive), dyspnea, stridor or wheezing are caused by the existence of a bronchial obstruction, while hemoptysis is due to the rupture of the tumor vessels. Carcinoid syndrome is less frequently encountered   and more difficult to clinically diagnose , but it occurs in most patients that have liver metastases. Symptoms consist of asthma-like symptoms, flushing, palpitations and diarrhea. Furthermore, a recurrent infectious episode may complicate disease evolution and recognition.
When the tumor is big enough to compress neighboring structures, it may induce hoarseness, chest pain or chylothorax. Large tumors are more often found in the right lung rather than the left. The patient may complain of paraplegia, vertebral pain or sensory deficit due to acute spinal cord compression. Upper limbs may be painful and occasionally present with muscular atrophy. Horner syndrome (miosis, hemifacial anhidrosis, and partial ptosis) is caused by Pancoast tumors. Sometimes, the physician encounters a superior vena cava syndrome, characterized by dilated upper extremities and jugular veins, facial edema, papilledema and mental changes. Patients may also exhibit low-grade fever and weight loss. Breath sounds may prove asymmetric on auscultation and this method sometimes reveals condensation (pneumonia or abscess) processes distal to the obstruction site. Auscultation is occasionally consistent with emphysema or pleural effusion . The tumor itself may cause increased work of breathing with intercostal retractions, dyspnea, orthopnea, and cyanosis.
Bronchial carcinoid has also been described in the pediatric population. This age group is often symptomatic and have recurrent pulmonary infectious episodes . If a cough or wheezing do not properly respond to standard therapy, bronchial adenoma or carcinoid suspicion should be rapidly raised and investigated .
Entire Body System
The diagnosis of bronchial adenoma in children is often delayed due to erroneous interpretation of the secondary manifestations of pneumonitis, fever, or wheezing. [ncbi.nlm.nih.gov]
[…] diagnostic CXR/Chest CT: atelectasis, post-obstructive pneumonia Clinical Wheezing Stridor Cough Post-Obstructive Pneumonia Lung Nodule (see Lung Nodule or Mass, [[Lung Nodule or Mass]]) Dyspnea Hemoptysis (see Hemoptysis, [[Hemoptysis]]): may occur Fever [mdnxs.com]
A 32-year-old Kashmiri woman was referred to our hospital with chief complaints of hemoptysis, cough, and fever of 2-year duration. She was diagnosed as pulmonary tuberculosis and took antitubercular treatment for 6 months. [lungindia.com]
Cough, fever, and sputum production result from complete obstruction of the bronchi, leading to collapse, infection, and destruction of the lung tissue on the other side of the obstruction. [emedicinehealth.com]
Abstract Of 16 patients with bronchial adenoma who were operated on at Beilinson Medical Center from 1967 to 1980, only three presented the "triad" of cough, hemoptysis, and recurrent pulmonary infections. [ncbi.nlm.nih.gov]
The majority of patients with this tumor complain of cough and hemoptysis. 4 The cough may be “dry” or productive of copious amounts of sputum, depending on the degree of parenchymal obstruction and secondary infection. [mdedge.com]
Symptoms bloody sputum cough wheezing recurrent pneumonia slowly resolving pneumonia collapse of a lung lobe or segment cough lasting more than 6 weeks. [medical-dictionary-search-engines.com]
The procedure was safe and none of the patients had massive hemoptysis following bronchoscopic biopsy. Limited follow-up revealed good results following surgery. [ncbi.nlm.nih.gov]
Bronchial adenoma commonly present as : (LQ) A Recurrent hemoptysis B Cough C Dysponea D Chest pain Ans. A Recurrent hemoptysis Bronchial adenoma: Rare, slow-growing. 90% are carcinoid tumours; 10% cylindromas. [gradestack.com]
(see Hemoptysis, [[Hemoptysis]]): may occur Fever/Weight loss : may occur Development of Higher Grade Malignancy within Bronchial Adenoma : most common with pleomorphic subtype Treatment Bronchoscopic Removal : fulguration/laser may be used for poor [mdnxs.com]
The commonest presenting symptoms were hemoptysis, persistent cough, dyspnea and chest pain. [ncbi.nlm.nih.gov]
The 1st case was a 46 year-old female with chief complaints of dyspnea and abnormal chest x-ray. The bronchoscopy revealed a tumor in the left main bronchus, and the biopsy showed a cylindroid type of bronchial adenoma. [jstage.jst.go.jp]
[…] occurs as sessile or polypoid mass in main or lobar bronchus EBB: diagnostic CXR/Chest CT: atelectasis, post-obstructive pneumonia Clinical Wheezing Stridor Cough Post-Obstructive Pneumonia Lung Nodule (see Lung Nodule or Mass, [[Lung Nodule or Mass]]) Dyspnea [mdnxs.com]
Symptoms like a cough (dry or productive), dyspnea, stridor or wheezing are caused by the existence of a bronchial obstruction, while hemoptysis is due to the rupture of the tumor vessels. [symptoma.com]
Persons with central lesions have symptoms of obstruction and bleeding, which include the following: Dyspnea (difficulty breathing) is caused by partial obstruction of the windpipe or large bronchi. [emedicinehealth.com]
- Dry Cough
Common Symptoms of Tracheal Cancer: Breathlessness Difficulty swallowing Coughing up blood Frequent chest infections Dry cough or hoarse voice Recurring fever Chills Wheezing or noisy breathing Smoking is also a risk factor. [wvcancercenter.com]
Blood workup in bronchial adenoma should include a complete blood cell count that will help differentiate pneumonia from other types of pulmonary condensation. The presence of anemia suggests significant blood loss by hemoptysis. A patient with severe respiratory distress should undergo an arterial blood gas determination, that may reveal decreased oxygen and increased carbon dioxide concentrations. A sputum culture is only useful if a distal infectious process exists. More specific markers are synaptophysin, calcitonin, bombesin, serotonin, neuron-specific enolase, corticotropin and antidiuretic hormone, keeping in mind that all of these are also increased in small cell lung cancer. Immunohistochemistry identifies tumor secretory substances.
The presence of a tumor can be suspected on a plain thoracic radiograph, but its type cannot be specified . Supplementary views, like the oblique ones, are sometimes useful. This investigation highlights the presence of different aspects, such as pleural effusion (that masks everything beneath it), a nodule or mass, an atelectasis area due to bronchial obstruction or infiltrative process. Hilar lymphadenopathy may signify infection or tumor . A normal radiological aspect does not necessarily exclude the disease. Therefore, in selected cases, a computed tomography (CT) scan can provide further information regarding calcification, compression, and location, as well as bronchiectasis or peripheral atelectasis. Contrast enhancement is homogeneous in typical carcinoid and less prominent in atypical one. Osseous metaplasia can also be encountered. Two-thirds of patients, those with somatostatin-positive tumors can be identified using octreotide or 99m technetium depreotide single-photon emission CT scanning, which represents alternative diagnosis methods.
Chest radiography Films may demonstrate a nodule, mass, infiltrate or atelectasis, mediastinal or hilar lymphadenopathy, or pleural effusion. Findings may be due to bronchial obstruction. Radiological findings are frequently nondiagnostic. [emedicine.medscape.com]
The chest x-ray showed an atelectasis in the right lower lung field, and a tumor was recognized in the right lower bronchus by bronchoscopy and bronchography. [jstage.jst.go.jp]
CT scanning should always be performed if the radiograph continues to show atelectasis over a period of 2-3 months. Definitive diagnosis is made with bronchoscopy. [indiacancersurgerysite.com]
Canalicular adenoma: Sebaceous adenoma: Clinical Endobronchial Nodule/Mass (see Obstructive Lung Disease, [[Obstructive Lung Disease]]) Diagnosis FOB: usually occurs as sessile or polypoid mass in main or lobar bronchus EBB: diagnostic CXR/Chest CT: atelectasis [mdnxs.com]
Cylindromas are always central Peripheral adenomas RUL, RML and lingula Carcinoid Tumors Clinical Findings Hemoptysis (40-50%) Atypical asthma Persistent cough Recurrent pneumonia Asymptomatic (10%) Carcinoid Tumors X-Ray Findings Atelectasis [learningradiology.com]
If your cancer does return, your doctor will try the same treatments, or new treatments to stop its spread. Support Treatment for bronchial adenoma can be stressful. [webmd.com]
Treatment Which treatment you get depends on your: Type and stage of cancer Age Health Preferences Options include: Surgery. This is the main treatment for bronchial adenomas. The surgeon will remove the cancer and some of the tissue around it. [alsehhat.com]
Treatment is by thoracotomy with total excision of the lesion. [ncbi.nlm.nih.gov]
So I think that in some sense I was lucky, the treatment was limited to surgery, which was done quickly and very neatly. [doclandmed.com]
We conclude that the long-term prognosis of patients with bronchial adenoma is excellent, and limited surgical procedure should be the treatment of choice whenever possible. [ncbi.nlm.nih.gov]
Mucous Gland Adenoma regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis, and additional useful information HERE. [dovemed.com]
Overall prognosis: 75% 15-year survival Associated with Cushing’s Disease Rare [learningradiology.com]
Concerning the possible etiology of bronchial adenoma, Stout 7 in 1943 reported finding all of the features of the oncocytes previously described by Hamperl. 6 Stout stressed the great difference between the oncocytes and other cells in the bronchial [mdedge.com]
Etiology Bronchial carcinoids are thought to arise from Kulchitsky cells. These neuroendocrine cells, formerly classified as amine precursor uptake and decarboxylation cells, produce and store biogenic amines and peptides. [thehealthscience.com]
[…] lesions with less cartilaginous and ductal differentiation Epidemiology Very rare ( 40 cases reported), predominantly in young adults, age range 8 - 74 years Possibly shows slight F M Sites Usually in trachea and major bronchi, rarely in distal bronchi Etiology [pathologyoutlines.com]
Epidemiology xxx Physiology Benign mucoepithelial tumor of the lung Mucoepithelial tumors: rare tumors that arise from the mucous glands of the upper airway (trachea/ bronchi)/ oropharynx (tumor arising from salivary gland is named for that origin, but [mdnxs.com]
Epidemiology This is a very rare tumour occurring from childhood to old age. Clinical features Patients usually present with features of obstruction. Radiology The tumour is usually central but may be peripheral, forming a "coin lesion". [e-immunohistochemistry.info]
Epidemiology Frequency United StatesBronchial adenomas represent 1-3% of pulmonary malignancies. Carcinoids account for approximately 85% of bronchial adenomas and 1-2% of all lung malignancies. [thehealthscience.com]
Epidemiology Frequency United States Bronchial adenomas represent 1-3% of pulmonary malignancies. Carcinoids account for approximately 85% of bronchial adenomas and 1-2% of all lung malignancies. [emedicine.medscape.com]
Pathophysiology Symptoms develop from the growth of the tumors within the tracheobronchial tree, with consequent obstruction leading to cough, hemoptysis, atelectasis, or pneumonia. [thehealthscience.com]
Pathophysiology Symptoms develop from the growth of the tumors within the tracheobronchial tree, with consequent obstruction leading to cough, hemoptysis, atelectasis, or pneumonia.  Adenoid cystic carcinoma behaves very similar to major and minor [emedicine.medscape.com]
[…] these are benign tumors and no malignant transformation is noted Please find comprehensive information on Pulmonary Mucous Gland Adenoma regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention [dovemed.com]
Deterrence/Prevention No preventive regimen has been established. Smoking cessation is always a good thing but has no specific effect on these tumors. [indiacancersurgerysite.com]
The combined use of two drugs that are prescribed for other conditions, eflonithine and sulindac, may prevent the development of adenomas or the recurrence of colon cancer. [encyclopedia.com]
However, the existence of a fibrous, firm sheath around the tumor can prevent adequate tissue sampling in 50% of the cases [ 15 ]. Chondromas Endobronchial Chondroma (EC) is also extremely rare. [omicsonline.org]
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