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Pathology of Alveolar Adenoma of the Lung - Top Ten Facts

Dr Sampurna Roy MD   

 

 

 

 

Low magnification showing sharp demarcation from the adjacent lung  parenchyma and cystic spaces larger in the central area of the tumour.

 

Courtesy: Nicolina De Rosa, Alfonso Maiorino, Ilaria De Rosa, Carlo Curcio, Carmine Sellitto, and Dario Amore, “CD34 Expression in the Stromal Cells of Alveolar Adenoma,” Case Reports in Medicine, vol. 2012, Article ID 913517, 4 pages, 2012. doi:10.1155/2012/913517

 

 
(1) Alveolar adenoma was described for the first time by Yousem and Hochholzer in 1986 and is sometimes referred to as "Yousem's tumour".

 

(2) It is a rare benign tumour of the lung showing proliferation of alveolar epithelium and septal mesenchyme.

 

(3) Patients with alveolar adenoma are usually asymptomatic and are diagnosed through the accidental discovery of a well-delineated nodule on a routine chest X-ray.

 

(4) Some authors have suggested that they may represent the benign counterpart of bronchioloalveolar carcinoma.

 

(5) Macroscopically, it is a well circumscribed and hemorrhagic lesion with cystic areas (usually measure less than 3 cm in maximal dimension).

 

(6) The most important histologic feature of the tumour are the multiple cystically dilated structures filled with proteinaceous material, with the larger cysts usually concentrated in the middle of the tumour.

 

(7) The dilated structures are lined by alveolar pneumocytes with hobnail appearance.

 

(8) The cystic spaces are separated by delicate myxoid stroma  containing collagen fibrils, prominent spindle or oval shaped cells and mild to moderate numbers of interstitial lymphocytes, plasma cells, and eosinophils.

Image1 ; Image2 ; Image3

 

(9) Immunohistochemical studies have consistently shown that the epithelial cells are positive for thyroid transcription factor 1 and almost all are cytokeratin positive.

 

(10)  Alveolar adenoma has unique histologic features, which should be distinguished from those of sclerosing hemangioma, lymphangioma, and bronchioloalveolar carcinoma.

 

 

Further reading:

Alveolar adenoma of the lung: a clinicopathological description of a case of this very unusual tumour. J Clin Pathol. 2005 Nov;58(11):1211-4. Halldorsson A  Dissanaike S Kaye KS.

Alveolar adenoma.

Alveolar adenoma of the lung: computed tomography and magnetic resonance imaging findings.

Alveolar adenoma.

Pulmonary nodule caused by an alveolar adenoma of the lung.

Alveolar adenoma.

 

 


 

 

 

 

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