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Objective To summarize the multi slice spiral computed tomography(MSCT)features of bronchiolar adenoma(BA).Methods The imaging data of 9 cases of BA confirmed by surgery and pathology were analyzed retrospectively,and relevant literature was also reviewed.Results Among the 9 cases of BA,there were 8 cases with peripheral BA(away from the pleura≤5 mm)inclu-ding 4 cases close to the pleura and 1 case in central area.BA were located in the superior lobe of the right lung in 3 cases,the middle lobe of the right lung in 2,the inferior lobe of the right lung in 2,and the inferior lobe of the left lung in 2.Five cases were solid nod-ules,2 were ground-glass nodules and other 2 were cystic cavity nodules.In 2 cases of the solid nodules,the boundary on the non-venous side was blurred.In the 1 case of the ground-glass nodule,linear and reticular shadows were observed in the lesion,accompanied by a blurred boundary.2 nodules had mild pleura indentation,and other 7 nodules were found blood vessels entering into or adhering to the lesion,3 of which were accompanied by vascular thickening.In 8 cases with 2-48 month followed up,1 cystic cavity nodule was accompa-nied by obstructive pneumonia and then inflammatory absorption,1 solid nodule enlarged accompanied by the appearance of vacuoles,and the rest 6 had no changes.One central type nodule was operated after the CT examination.Conclusion BA are mainly manifes-ted as peripheral nodules of the lung,mostly close to the pleura and away from the pleura≤5 mm.Most BA are solid nodules,and sometimes are ground-glass or cystic cavity nodules.Some nodules show blurred boundaries or inflammation on the non-venous side,and few nodules increase during follow-up,with or without small vacuoles.
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@#Objective To analyze the pathological manifestations and imaging characteristics of bronchiolar adenoma (BA). Methods The clinical data of 11 patients with BA who received surgeries in our hospital from January 2019 to September 2020 were retrospectively analyzed, including 5 males and 6 females aged 40-73 (62.40±10.50) years. The intraoperative rapid freezing pathological diagnosis, postoperative pathological classification, cell growth pattern, nuclear proliferation index Ki-67 and other immunohistochemical staining combined with preoperative chest CT imaging characteristics were analyzed. Results The average preoperative observation time was 381.10±278.28 d. The maximum diameter of imaging lesions was 5-27 (10.27±6.34) mm. Eight (72.7%) patients presented with irregular morphology of heterogeneous ground-glass lesions, and 3 (27.3%) patients presented with pure ground-glass lesions. There were 10 (90.9%) patients with vascular signs, 8 (72.7%) patients with vacuolar signs, 1 (9.1%) patient with bronchus sign, 3 (27.3%) patients with pleural traction and 9 (81.8%) patients with burr/lobular sign. The surgical methods included sub-lobectomy in 10 patients and lobectomy in 1 patient. Five (45.5%) patients were reported BA by intraoperative frozen pathology. The postoperative pathological classification included 8 patients with distal-type and 3 patients with proximal-type, and the maximum diameter of the lesions was 4-20 (8.18±5.06) mm. Eight (72.7%) patients showed characteristic bilayer cell structure under microscope, and 10 (90.9%) patients showed thyroid transcription factor 1 expression in pathological tissues. The expression of NapsinA in intracavity cells was found in 9 (81.8%) patients. The Ki-67 index of the lesion tissue was 1%-5% (3.22%±1.72%). Conclusion The pathological features and imaging findings of BA confirm the premise that BA is a neoplastic lesion. However, to identify BA as a benign or inert tumor needs more clinical data and evidence of molecular pathological studies.
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Objective:To investigate the CT characteristics of bronchiolar adenoma (BA) in order to improve the understanding of the disease and to increase the accuracy of preoperative diagnosis.Methods:The clinical, imaging and pathological data of 69 patients with BA confirmed by surgical resection and pathology at Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences from December 2018 to November 2020 were retrospectively reviewed. The type, the location and the size of the lesions, the distance from the lesion to the adjacent pleura, as well as the morphological characteristics including lobulation, spiculation, bubble lucency and pleural indentation were analyzed and recorded. The follow-up CT data were also reviewed.Results:Among 69 BAs, pre-operation chest CT displayed visible lesion in 25 cases, and showed negative in 44 cases. According to the lesion density, the 25 BAs on CT images were classified into solid type ( n=8), ground-glass type ( n=8), cystic type ( n=6) and cyst type ( n=3). There were 15 lesions in the right lung (1 in the upper, 2 in the middle and 12 in the lower lobe) and 10 lesions in the left lung (5 in the upper and 5 in the lower lobe). Ten lesions were found adjacent to the pleura. As for the other 15 cases, the distance between the lesion and the adjacent pleura was (10±7) mm. Calcification was displayed in one cystic type BA case. The maximum diameter of 25 BAs were 4.4-30.3 mm, with the median value of 9.6 mm. The lobulation, spiculation, bubble lucency, and pleural indentation of lesions were detected in 20, 11, 12, and 6 cases. In total there were 11 patients received the preoperative follow-up CT, and 4 cases showed enlargement in diameter (including 2 cases of solid type, 1 of ground-glass type and 1 of cystic type). The growth rate was 0.43-2.14 mm/year, with the median value of 1.67 mm/year. Imaging signs including spiculation ( n=1), bubble lucency ( n=1) and lobulation ( n=1) were newly discovered on the preoperative follow-up CT. Postoperative follow-up CT was performed in 13 cases, without any recurrence or metastasis found. Conclusions:CT imaging features of BA usually display as a single pulmonary solid or ground-glass nodule, and also can be presented as cystic or cyst type in several cases. Lesions can appear the lobulation, spiculation and bubble lucency, with calcification rarely found. A few of BA cases can enlarge during follow-up.