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Girvin F, Phan A, Steinberger S, Shostak E, Bessich J, Zhou F, Borczuk A, Brusca-Augello G, Goldberg M, Escalon J. Malignant and Benign Tracheobronchial Neoplasms: Comprehensive Review with Radiologic, Bronchoscopic, and Pathologic Correlation. Radiographics 2023; 43:e230045. [PMID: 37561643 DOI: 10.1148/rg.230045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Tracheobronchial neoplasms are much less common than lung parenchymal neoplasms but can be associated with significant morbidity and mortality. They include a broad differential of both malignant and benign entities, extending far beyond more commonly known pathologic conditions such as squamous cell carcinoma and carcinoid tumor. Airway lesions may be incidental findings at imaging or manifest with symptoms related to airway narrowing or mucosal irritation, invasion of adjacent structures, or distant metastatic disease. While there is considerable overlap in clinical manifestation, imaging features, and bronchoscopic appearances, an awareness of potential distinguishing factors may help narrow the differential diagnosis. The authors review the epidemiology, imaging characteristics, typical anatomic distributions, bronchoscopic appearances, and histopathologic findings of a wide range of neoplastic entities involving the tracheobronchial tree. Malignant neoplasms discussed include squamous cell carcinoma, malignant salivary gland tumors (adenoid cystic carcinoma and mucoepidermoid carcinoma), carcinoid tumor, sarcomas, primary tracheobronchial lymphoma, and inflammatory myofibroblastic tumor. Benign neoplasms discussed include hamartoma, chondroma, lipoma, papilloma, amyloidoma, leiomyoma, neurogenic lesions, and benign salivary gland tumors (pleomorphic adenoma and mucous gland adenoma). Familiarity with the range of potential entities and any distinguishing features should prove valuable to thoracic radiologists, pulmonologists, and cardiothoracic surgeons when encountering the myriad of tracheobronchial neoplasms in clinical practice. Attention is paid to any features that may help render a more specific diagnosis before pathologic confirmation. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Francis Girvin
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Alexander Phan
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Sharon Steinberger
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Eugene Shostak
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Jamie Bessich
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Fang Zhou
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Alain Borczuk
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Geraldine Brusca-Augello
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Margaret Goldberg
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Joanna Escalon
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
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Wang SC, Yin LK, Zhang Y, Xue LM, Ye JD, Tao GY, Yu H, Qiang JW. CT diagnosis and prognosis prediction of tracheal adenoid cystic carcinoma. Eur J Radiol 2021; 140:109746. [PMID: 33992979 DOI: 10.1016/j.ejrad.2021.109746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/08/2021] [Accepted: 04/26/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate computed tomography (CT) features and establish a predictive model for the clinical diagnosis and prognosis of tracheal adenoid cystic carcinoma (ACC). METHOD From January 2010 to December 2018, 82 patients with tracheal tumors, including 46 patients with ACC confirmed by surgery and histopathology, were enrolled in this study. These patients' clinicopathologic information, CT features and survival outcomes were recorded and analyzed. Independent predictors of diagnosis and prognosis of tracheal ACC were determined by both univariate and multivariate analyses. RESULTS Compared with tracheal non-ACC patients, univariate analysis showed that ACC patients were more likely to have extensive longitudinal length (p < 0.001) and to appear as annular wall thickening (p = 0.001), transmural growth (p = 0.036), poorly defined border (p = 0.003) and mild enhancement (p = 0.001). Multivariate logistic analysis showed that longitudinal length and enhancement degree were independent predictors of tracheal ACC. The 3-year and 5-year disease-free survival (DFS) were 75.7 % and 64.5 %, respectively. Longitudinal length (≥ 34 mm), transverse length (≥ 20 mm) and transmural growth were associated with poor DFS in univariate analysis. After multivariate adjustment, only transverse length (≥ 20 mm) was an adverse prognostic factor for DFS (hazard ratio = 4.594, 95 % confidence interval = 1.240-17.017; p = 0.022). CONCLUSIONS CT longitudinal length and enhancement degree of tumors showed satisfactory discrimination for tracheal ACC. Excessive CT transverse length might be an unfavorable indicator for ACC recurrence and could be helpful for predicting the survival outcomes of ACC at the initial diagnosis.
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Affiliation(s)
- Shu Chao Wang
- Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China
| | - Le Kang Yin
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China
| | - Yu Zhang
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China
| | - Li Min Xue
- Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China; Shanghai Institute of Imaging Medicine, Fudan University, 180 Fenglin Road, Shanghai, 200030, China
| | - Jian Ding Ye
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China
| | - Guang Yu Tao
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China
| | - Hong Yu
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China.
| | - Jin Wei Qiang
- Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China.
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Marchionatti E, Van der Vekens E, Peters LM, Kaiponen TS, Berenguer Veiga I, Zanolari P. Solitary tracheal B-cell lymphoma in an adult alpaca (Vicugna pacos). BMC Vet Res 2020; 16:429. [PMID: 33167982 PMCID: PMC7653881 DOI: 10.1186/s12917-020-02640-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 10/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This report describes a case of solitary tracheal lymphoma in a 14-year-old alpaca mare. CASE PRESENTATION The alpaca was referred for dyspnea and inspiratory noise. The clinical examination included complete blood cell count, blood chemistry, endoscopy, ultrasound, radiographs, and computed tomography (CT). A solitary tracheal intraluminal and juxtatracheal lymphoma was diagnosed by fine needle aspiration (FNA). The owner requested euthanasia due to the uncertain prognosis. At postmortem examination, the presence of solitary lymphoma without involvement of other organs was confirmed. Immunohistochemical analysis confirmed a B-cell origin. CONCLUSIONS Although multicentric lymphoma is the most commonly described neoplasia affecting South American camelids (SAC), solitary forms of the disease may occur.
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Affiliation(s)
- Emma Marchionatti
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bremgartenstrasse 109A, 3012, Bern, Switzerland.
| | - Elke Van der Vekens
- Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Länggassstrasse 124, 3012, Bern, Switzerland
| | - Laureen Michèle Peters
- Clinical Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Länggassstrasse 124, 3012, Bern, Switzerland
| | - Taina Susanna Kaiponen
- Institute for Veterinary Pathology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012, Bern, Switzerland
| | - Inês Berenguer Veiga
- Institute for Veterinary Pathology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012, Bern, Switzerland
| | - Patrik Zanolari
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bremgartenstrasse 109A, 3012, Bern, Switzerland
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Little BP, Duong PAT. Imaging of Diseases of the Large Airways. Radiol Clin North Am 2016; 54:1183-1203. [PMID: 27719983 DOI: 10.1016/j.rcl.2016.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Imaging of the large airways is key to the diagnosis and management of a wide variety of congenital, infectious, malignant, and inflammatory diseases. Involvement can be focal, regional, or diffuse, and abnormalities can take the form of masses, thickening, narrowing, enlargement, or a combination of patterns. Recognition of the typical morphologies, locations, and distributions of large airways disease is central to an accurate imaging differential diagnosis.
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Affiliation(s)
- Brent P Little
- Department of Radiology and Imaging Sciences, Emory University Hospital, Emory University School of Medicine, Clinic Building A, 1365 Clifton Road Northeast, Atlanta, GA 30322, USA.
| | - Phuong-Anh T Duong
- Department of Radiology and Imaging Sciences, Emory University Hospital, Emory University School of Medicine, Clinic Building A, 1365 Clifton Road Northeast, Atlanta, GA 30322, USA
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