Page 44 - ECBIP 2021_Program

6th European Congress ECBIP 15 - 17
Book of Abstracts
for Bronchology and
Interventional Pulmonology ATHENS - GREECE 2021
OCTOBER
MODERATED e-POSTER SESSION 01:
Central Airway management
MUCOUS GLAND ADENOMA OF THE TRACHEA
Iraklis Titopoulos, Thomas Zarampoukas, Nikos Siafakas
Athens Medical Group,Thessaloniki,Greece
PP07
Mucous Gland Adenoma (MGA) is a rare tumor originating from the mucous secreting glands of the airway mucosa. The majority arises within the bronchi and rarely within the trachea. A case of a trachea MGA is presented. A 75 years male, heavy smoker, was referred with cough, wheezing and dyspnea worsening in the last 2 months. A flow-volume loop showed a pattern of fixed extra-thoracic obstruction. Chest x-ray was normal whereas the chest CT scan revealed the presence of an oval-shaped mass, with a broad base, located in the upper tracheal lumen, 1.7 cm below the vocal cords. The patient underwent a flexible bronchoscopy under local anesthesia and mild sedation, which revealed the presence of an endotracheal well defined mass with a smooth surface and marked vascularity causing severe obstruction. The surrounding mucosa and tracheal semicircles appeared to be normal. The mass was completely resected using a polyloop-Olympus device. APC was performed for control of bleeding prior to definitive resection. The duration of the procedure was 22 min and it was well tolerated by the patient. The patient showed immediately complete remission of symptoms and he left the hospital the same day. No significant complications observed. Microscopically, the tumor consisted of arranged cysts and adenoid glands without cytological atypia. Focally in the cylindrical cells oncocytics characters were observed. Focally were present slightly dilated adenoid formations containing mucous. The intervening stroma consisted of delicate connective tissue.The tumor was well circumscribed.The external surface lined by respiratory epithelium, with absence of cellular atypia and presence of foci of incomplete squamous metaplasia. In the subepithelial layer an area of low-to-moderate grade of non-specific chronic inflammation was observed. The mucoid material of the cysts and the cytoplasm of several cells of the glands were positive for PAS stain. Immunohistochemically the tumor cells were positive for CK7, a few cells were positive for TTF-1 and all the tumor cells were negative for P40. Positivity for TTF-1 and P40 was observed in the myoepithelial cells. Thus, the diagnosis of a MGA was made. In conclusion, MGA of trachea remains an extremely rare benign tumor. It may be present for a long time before the correct diagnosis is made and provoke severe obstruction worsening patient’s symptoms, especially in case of underlying disease. Bronchoscopic resection remains the treatment of choice in most of the cases. Early recognition of this rare tumor is crucial.
Figure 1: A Gigantic Mucous Gland Adenoma Figure 2: An oval-shaped mass, with a broad base, located in the upper of the Trachea tracheal lumen, 1.7 cm below the vocal cords, on chest CT scan.
44 6th European Congress for Bronchology and Interventional Pulmonology