Adenoma of the Bronchus
Bronchial adenoma is a type of tumor peculiar to the trancheobronchial tree about which controversy has existed for fifteen years. Disagreement among pathologists as to terminology and interpretation of the morphologic picture hinders proper classification and correct management. The great variability in the clinical course of malignant lung tumors in general also helps confuse the issue. Undoubtedly many of these tumors have been classified adenocarcinoma, alveolar carcinoma, and mucous gland carcinoma, the true nature of the lesion not being recognized.
Two widely different opinions exist as to proper management of bronchial adenomas. One group classifies the tumors as benign and treats them by bronchoscopic removal.1 By the second group they are considered malignant or potentially malignant, and lobectomy or pneumonectomy is recommended.2
Because of the tumors’ glandlike structure and absence of the usual criteria of malignancy, the term benign glandular tumor of the bronchus has been suggested. Ultimately malignancy may be evident by direct extension and involvement of adjacent or distal structures. The term mixed tumors is advocated by Womack and Graham,3 because of the similarity in behavior and origin of this neoplasm to mixed tumors of the parotid gland. They advise regarding the neoplasms as potentially malignant, although many are benign when first recognized.
Incidence. Bronchial adenoma is not uncommon and must be considered in every case of bronchial obstruction. In eighteen months I encountered 5 cases diagnosed histologically as bronchial adenoma. Adenoma is most frequently observed in young women and in the second and third decades of life. . .