Skip to main content
Thorax logoLink to Thorax
. 1976 Jun;31(3):245–253. doi: 10.1136/thx.31.3.245

Bronchial adenoma: review of 18-year experience at the Brompton Hospital.

R M Lawson, L Ramanathan, G Hurley, K W Hinson, S C Lennox
PMCID: PMC470409  PMID: 181862

Abstract

Continued uncertainty about the prognosis for patients with bronchial adenomata led to a review of the experience of this condition in the Brompton Hospital. Of 72 patients seen between January 1955 and December 1972, 39 were women and 33 men, mean age 45 years, range 9-73 years. The commonest presenting symptoms were haemoptysis, cough, sputum, and repeated chest infections. Positive bronchoscopic biopsy occurred in 35 of 43 cases; five of these were originally reported as carcinomata, of oat-cell type in four. Plain chest film abnormality occurred in 69 patients. Seventy-three operative procedures comprised two endoscopic removals, two wedge resections, six bronchotomies, five pneumonectomies, and 58 lobectomies (seven with sleeve resection). Recurrence in three of six bronchotomies--two with adenoid cystic carcinomata (cylindromata)--necessitated further surgery. Lobectomy and lymph node dissection is usually the operation of choice. Histology confirmed 67 carcinoids (eight with atypical histology or lymph node metastases), two adenoid cystic carcinomata, one muco-epidermoid, and two mucous gland adenomata. Prolonged follow-up is especially indicated in patients with adenoid cyst carcinoma and in those with atypical or metastatic carcinoid histology. Although such pathology is not incompatible with long survival, of 10 patients in these categories, all five late deaths were probably related to the tumour. However, of 57 patients considered to have had typical carcinoid histology and adequate removal of the tumour, there has to date been no tumour-related death, but one patient developed radiosensitive atypical carcinoid tracheal tumours nine years later. The actuarially assessed survival of 71 patients undergoing surgery for bronchial adenomata was 75% at 15 years. Specific tumour types should replace the term bronchial adenoma.

Full text

PDF
245

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson R. P., Bonchek L. I., Grunkemeier G. L., Lambert L. E., Starr A. The analysis and presentation of surgical results by actuarial methods. J Surg Res. 1974 Mar;16(3):224–230. doi: 10.1016/0022-4804(74)90035-3. [DOI] [PubMed] [Google Scholar]
  2. Anderson R. P., Bonchek L. I., Grunkemeier G. L., Lambert L. E., Starr A. The analysis and presentation of surgical results by actuarial methods. J Surg Res. 1974 Mar;16(3):224–230. doi: 10.1016/0022-4804(74)90035-3. [DOI] [PubMed] [Google Scholar]
  3. Arrigoni M. G., Woolner L. B., Bernatz P. E. Atypical carcinoid tumors of the lung. J Thorac Cardiovasc Surg. 1972 Sep;64(3):413–421. [PubMed] [Google Scholar]
  4. Bass M. Sudden sniffing death. JAMA. 1970 Jun 22;212(12):2075–2079. [PubMed] [Google Scholar]
  5. Bensch K. G., Corrin B., Pariente R., Spencer H. Oat-cell carcinoma of the lung. Its origin and relationship to bronchial carcinoid. Cancer. 1968 Dec;22(6):1163–1172. doi: 10.1002/1097-0142(196811)22:6<1163::aid-cncr2820220612>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  6. Bower G. Bronchial adenoma. A review of twenty-eight cases. Am Rev Respir Dis. 1965 Oct;92(4):558–563. doi: 10.1164/arrd.1965.92.4.558. [DOI] [PubMed] [Google Scholar]
  7. Clark D. G., Tinston D. J. Cardiac effects of isoproterenol, hypoxia, hypercapnia and fluorocarbon propellants and their use in asthma inhalers. Ann Allergy. 1972 Sep;30(9):536–541. [PubMed] [Google Scholar]
  8. Donahue J. K., Weichert R. F., Ochsner J. L. Bronchial adenoma. Ann Surg. 1968 Jun;167(6):873–885. doi: 10.1097/00000658-196806000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. GILMAN R. A., KLASSEN K. P., SCARPELLI D. G. Mucous gland adenoma of bronchus; report of a case with histochemical study of secretion. Am J Clin Pathol. 1956 Feb;26(2):151–154. doi: 10.1093/ajcp/26.2.151. [DOI] [PubMed] [Google Scholar]
  10. Giustra P. E., Stassa G. The multiple presentations of bronchial adenomas. Radiology. 1969 Nov;93(5):1013–1019. doi: 10.1148/93.5.1013. [DOI] [PubMed] [Google Scholar]
  11. Heimburger I. L., Kilman J. W., Battersby J. S. Peripheral bronchial adenomas. J Thorac Cardiovasc Surg. 1966 Oct;52(4):542–549. [PubMed] [Google Scholar]
  12. MATTINGLY T. W. The functioning carcinoid tumor-a new clinical entity; review of the clinical features of the nonfunctioning and functioning carcinoid, including a review of thirty-eight cases from the literature. II. Med Ann Dist Columbia. 1956 Jun;25(6):304–passim. [PubMed] [Google Scholar]
  13. MCBURNEY R. P., CLAGETT O. T., MCDONALD J. R. Obstructive pneumonitis secondary to bronchial adenoma. J Thorac Surg. 1952 Oct;24(4):411–419. [PubMed] [Google Scholar]
  14. Meffert W. G., Lindskog G. E. Bronchial adenoma. J Thorac Cardiovasc Surg. 1970 Apr;59(4):588–602. [PubMed] [Google Scholar]
  15. OVERHOLT R. H., BOUGAS J. A., MORSE D. P. Bronchial adenoma; a study of 60 patients with resections. Am Rev Tuberc. 1957 Jun;75(6):865–884. doi: 10.1164/artpd.1957.75.6.865. [DOI] [PubMed] [Google Scholar]
  16. OZLU C., CHRISTOPHERSON W. M., ALLEN J. D., Jr Mucoepidermoid tumors of the bronchus. J Thorac Cardiovasc Surg. 1961 Jul;42:24–31. [PubMed] [Google Scholar]
  17. REID J. D. Adenoid cystic carcinoma (cylindroma) of the bronchial tree. Cancer. 1952 Jul;5(4):685–694. doi: 10.1002/1097-0142(195207)5:4<685::aid-cncr2820050406>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  18. SMETANA H. F., IVERSON L., SWAN L. L. Bronchogenic carcinoma; an analysis of 100 autopsy cases. Mil Surg. 1952 Nov;111(5):335–351. [PubMed] [Google Scholar]
  19. SOUTTER L., SNIFFEN R. C., ROBBINS L. L. A clinical survey of adenomas of the trachea and bronchus in a general hospital. J Thorac Surg. 1954 Oct;28(4):412-28; discussion, 428-30. [PubMed] [Google Scholar]
  20. Speizer F. E., Doll R., Heaf P. Observations on recent increase in mortality from asthma. Br Med J. 1968 Feb 10;1(5588):335–339. doi: 10.1136/bmj.1.5588.335. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Speizer F. E., Doll R., Heaf P., Strang L. B. Investigation into use of drugs preceding death from asthma. Br Med J. 1968 Feb 10;1(5588):339–343. doi: 10.1136/bmj.1.5588.339. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. THOMAS C. P., MORGAN A. D. Ossifying bronchial adenoma. Thorax. 1958 Dec;13(4):286–293. doi: 10.1136/thx.13.4.286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Tolis G. A., Fry W. A., Head L., Shields T. W. Bronchial adenomas. Surg Gynecol Obstet. 1972 Apr;134(4):605–610. [PubMed] [Google Scholar]
  24. Turnbull A. D., Huvos A. G., Goodner J. T., Beattie E. J., Jr The malignant potential of bronchial adenoma. Ann Thorac Surg. 1972 Nov;14(5):453–464. doi: 10.1016/s0003-4975(10)65256-3. [DOI] [PubMed] [Google Scholar]
  25. WEISEL W., LEPLEY D., Jr, WATSON R. R. Respiratory tract adenomas. A ten-year survey. Ann Surg. 1961 Dec;154:898–902. [PMC free article] [PubMed] [Google Scholar]
  26. Williams F. M., Draffan G. H., Dollery C. T., Clark J. C., Palmer A. J., Vernon P. Use of 18F labelled fluorocarbon-11 to investigate the fate of inhaled fluorocarbons in man and in the rat. Thorax. 1974 Jan;29(1):99–103. doi: 10.1136/thx.29.1.99. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. ZELLOS S. Bronchial adenoma. Thorax. 1962 Mar;17:61–68. doi: 10.1136/thx.17.1.61. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES