Glandular papilloma of the lung

Definition

A papillary tumour lined by columnar cells

Epidemiology

These tumours are exceedingly rare². No aetiological factor has been identified³.

Clinical features

Presentation is usually with obstructive symptoms.

Macroscopic appearances

Endobronchial lesions are polypoidal. If within a bronchiole, they may appear solid.

Histopathology

The fibrous stalks are thick and covered by glandular epithelium. The epithelium may be ciliated or not. Goblet cells may be seen. Nuclear atypia and mitoses are absent.

Immunohistochemistry

Has not been investigated.

Differential diagnosis

Mixed squamous and glandular papillomas, exceedingly rare, show a mix of squamous and glandular epithelium, of which the latter should constitute at last one third.
Inflammatory polyps lack an epithelial component.
Papillary variant of mucous gland adenoma: lacks fibrovascular stromal cores.
Papillary adenomas: are not within airways.
Papillary adenocarcinoma: shows atypia and invasion.

Management

Excision.

Prognosis

Benign. May recur after incomplete excision³.

References

⁰Tumours of the Lung, Pleura, Thymus and Heart. WHO Classification of Tumours. IARC Press 2004.

¹Ashmore PG. Papilloma of the bronchus: case report. J Thorac Surg 1954; 27:293-4

²Basheda S, Gephardt GN,Stoller JK. Columnar papilloma of the bronchus. Case report and literature review. Am Rev Respir Dis 1991; 144:1400-2

³Flieder DB, Koss MN, Nicholson A, et al. Solitary pulmonary papillomas in adults: a clinicopathologic and in situ hybridization study of 14 cases combined with 27 cases in the literature. Am J Surg Pathol 1998; 22:1328-42

This page last revised 8.4.2005.