J Korean Med Sci.  2007 Apr;22(2):373-376. 10.3346/jkms.2007.22.2.373.

Primary Polymorphous Low-Grade Adenocarcinoma of Lung Treated by Sleeve Bronchial Resection: A Case Report

• Cho KD
• Jung JH
• Cho DG
• Jo MS
• Yoo J
• Song SH
• Shim BY
• Kim CH
• Kim HK

• KMID: 1713205
• DOI: http://doi.org/10.3346/jkms.2007.22.2.373

Abstract

We report a surgical case of primary polymorphous low-grade adenocarcinoma (PLGA) of the minor salivary gland-type of the lung. A PLGA originating from the right upper lobar bronchial inlet was successfully treated by sleeve right upper lobectomy. PLGAs are thought to be indolent tumors that are preferentially localized to the palate, and they affect the minor salivary glands almost exclusively. Until now, two cases of distant metastases to the lung have been reported in the English literature. To the best of our knowledge, only one case of PLGA of minor salivary glandtype of the lung without evidence of a previous oropharyngeal primary tumor has been reported in the English literature. But the case was not a single lesion; it was bilateral tumors accompanied by tumors of the cervical lymph nodes. We report here the first case of a single primary PLGA of the minor salivary gland-type of the lung, which was successfully treated by sleeve bronchial resection of right upper lobe.

Keyword

PLGA; Lung; Primary Tumor; Sleeve Lobectomy

MeSH Terms

Treatment Outcome
Salivary Gland Neoplasms/pathology/*surgery
Lung Neoplasms/pathology/*secondary/*surgery
Humans
Female
Bronchi/*surgery
Aged
Adenocarcinoma/pathology/*secondary/*surgery

Figure

• 

  Fig. 1 (A) Preoperative chest roentgenogram. (B) Preoperative bronchoscopic finding of the lobulated intraluminal mass in the right main bronchus. (C) Bronchoscopic finding on the 5th postoperative day. (D) Postoperative chest roentgenogram on the postoperative 9th day.

• 

  Fig. 2 The low-power view shows the various architectural patterns (arrow) including ductal, cystic and trabecular growth (H&E stain, ×40).

• 

  Fig. 3 Higher magnification shows the strands of cells with duct-like structures.; the cytoplasm is scanty (H&E stain, ×200).

• 

  Fig. 4 Most of the tumor cells show diffuse strong staining for epithelial membrane antigen (H&E stain, ×200).

Reference

1. Evans HL, Batsakis JG. Polymorphous low-grade adenocarcinoma of minor salivary glands. A study of 14 cases of a distinctive neoplasm. Cancer. 1984. 53:935–942.

2. Vincent SD, Hammond HL, Finkelstein MW. Clinical and therapeutic features of polymorphous low-grade adenocarcinoma. Oral Surg Oral Med Oral Pathol. 1994. 77:41–47.

3. Gnepp DR, Chen JC, Warren C. Polymorphous low-grade adenocarcinoma of minor salivary gland. An immunohistochemical and clinicopathologic study. Am J Surg Pathol. 1988. 12:461–468.

4. Tanaka F, Wada H, Inui K, Mizuno H, Ike O, Yokomise H, Fukuse T, Hitomi S, Shoji K, Nakashima Y. Pulmonary metastasis of polymorphous low-grade adenocarcinoma of the minor salivary gland. Thorac Cardiovasc Surg. 1995. 43:178–180.

5. Hannen EJ, Bulten J, Festen J, Wienk SM, de Wilde PC. Polymorphous low grade adenocarcinoma with distant metastases and deletions on chromosome 6q23-qter and 11q23-qter: a case report. J Clin Pathol. 2000. 53:942–945.

6. Lee VK, McCaughan BC, Scolyer RA. Polymorphous low-grade adenocarcinoma in the lung: a case report. Int J Surg Pathol. 2004. 12:287–294.

7. Ellis LG, Auclair Paul L. Tumors of the Salivary Glands. atlas of tumor pathology. 1996. Washington, DC: Armed Forces Institute of Pathology;Third series. Fascicle no.17.

8. Simpson RH, Reis-Filho JS, Pereira EM, Ribeiro AC, Abdulkadir A. Polymorphous low-grade adenocarcinoma of the salivary glands with transformation to high-grade carcinoma. Histopathology. 2002. 41:250–259.

9. Castle JT, Thompson LD, Frommelt RA, Wenig BM, Kessler HP. Polymorphous low-grade adenocarcinoma: a clinicopathologic study of 164 cases. Cancer. 1999. 86:207–219.

10. Thomas PC. Conservative resection of the bronchial tree. J R Coll Surg Edinb. 1956. 1:169–186.