Mixed Squamous/Glandular Papilloma of the Lung, From Radiological Suspicion to Histopathological Confirmation. A case report
Papiloma mixto escamoso y glandular de pulmón, de la sospecha clínico-radiológica hasta la confirmación histopatológica. Un reporte de caso.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Ninguna publicación, nacional o extranjera, podrá reproducir ni traducir sus artículos ni sus resúmenes sin previa autorización escrita del editor; sin embargo los usuarios pueden descargar la información contenida en ella, pero deben darle atribución o reconocimiento de propiedad intelectual, deben usarlo tal como está, sin derivación alguna.
Pulmonary papillomas, comprising less than 1% of primary lung neoplasms, typically manifest as solitary lesions within the airways, with a predilection for occurrence between the fifth and sixth decades of life, predominantly in males. According to the World Health Organization (WHO) classification, respiratory papillomas fall into three categories: squamous cell, glandular, and mixed squamous cell glandular (MSGP), with squamous cell papilloma being the most prevalent. MSGPs, distinguished by their papillary configuration with both squamous and glandular epithelium, represent the rarest variant. In this case, a 70-year-old woman MSGP presented with a one-year history of cough, mucoid expectoration, right dorsal pain exacerbated by coughing, and hypoxemia. A juxta-aortic mass was reported on chest CT, which was strongly suggestive of malignancy. PET/CT confirmed hypermetabolism in the mass (SUVmax 25). Facing inconclusive transcutaneous biopsy results, the medical team opted for a left lower lobectomy with lymph node dissection. Histopathological examination disclosed a 4.5 cm MSGP lesion with papillae, fibrovascular cores, squamous cells exhibiting cytological atypia, and focal high-grade dysplasia. This case highlights the rarity of MSGP and its diagnostic challenges, emphasizing the need for thorough evaluation and surgical intervention. The patient's symptomatic improvement and absence of papilloma recurrence during medical follow-up underscore the favorable outcomes post-surgery.
Article visits 4 | PDF visits
Downloads
- Yabuki K, Matsuyama A, Obara K, Takenaka M, Tanaka F, Nakatani Y, et al. A unique case of a huge mixed squamous cell and glandular papilloma of non-endobronchial origin with a peripheral growth. Respir Med Case Reports [Internet]. 2018;24:108–12. doi: 10.1016/j.rmcr.2018.05.001.
- Tryfon S, Dramba V, Zoglopitis F, Iakovidis D, Sakkas L, Kontakiotis T, et al. Solitary Papillomas of the Lower Airways: Epidemiological, Clinical, and Therapeutic Data during a 22-Year Period and Review of the Literature. J Thorac Oncol [Internet]. 2012 Apr;7(4):643–8. doi: 10.1097/JTO.0b013e3182468d06.
- Flieder DB, Koss MN, Nicholson A, Sesterhenn IA, Petras RE, Travis WD. Solitary Pulmonary Papillomas in Adults. Am J Surg Pathol [Internet]. 1998 Nov;22(11):1328–42. doi: 10.1097/00000478-199811000-00003.
- Travis WD, Brambilla E, Nicholson AG, Yatabe Y, Austin JHM, Beasley MB, et al. The 2015 World Health Organization Classification of Lung Tumors. J Thorac Oncol [Internet]. 2015 Sep;10(9):1243–60. doi: 10.1097/JTO.0000000000000630.
- Alagusundaramoorthy S, Agrawal A. Respiratory papillomas. Lung India [Internet]. 2016;33(5):522. doi: 10.4103/0970-2113.188973.
- Lin D, Xing X, Ran W, Zhao H, Li G, Xu J, et al. Pulmonary peripheral glandular papilloma and mixed squamous cell and glandular papilloma frequently harbour the BRAF V600E mutation. Histopathology [Internet]. 2020 Jun 11;76(7):997–1004. doi: 10.1111/his.14098.
- Li F, He M, Li F, Li Y, Song Y. Histologic characteristics and prognosis of lung mixed squamous cell and glandular papilloma: six case reports. Int J Clin Exp Pathol [Internet]. 2019;12(9):3542–8.
- Yousem SA, Paul Ohori N, Sonmez-Alpan E. Occurrence of Human Papillomavirus DNA in Primary Lung Neoplasms. Cancer [Internet]. 1992 Feb 1;69(3):693–7. doi: 10.1002/1097-0142(19920201)69:3<693::aid-cncr2820690316>3.0.co;2-y.
- Béjui-Thivolet F, Liagre N, Chignol MC, Chardonnet Y, Patricot LM. Detection of human papillomavirus DNA in squamous bronchial metaplasia and squamous cell carcinomas of the lung by in situ hybridization using biotinylated probes in paraffin-embedded specimens. Hum Pathol [Internet]. 1990 Jan;21(1):111–6. doi: 10.1016/0046-8177(90)90082-g.
- Fortes HR, von Ranke FM, Escuissato DL, Araujo Neto CA, Zanetti G, Hochhegger B, et al. Recurrent respiratory papillomatosis: A state-of-the-art review. Respir Med [Internet]. 2017 May;126:116–21. doi: 10.1016/j.rmed.2017.03.030.
- Sasaki E, Masago K, Fujita S, Iwakoshi A, Kuroda H, Hosoda W. AKT1 Mutations in Peripheral Bronchiolar Papilloma. Am J Surg Pathol [Internet]. 2021 Jan;45(1):119–26. doi: 10.1097/PAS.0000000000001573.
- Wohlschläger J, Welter S, Stamatis G, Theegarten D, Hager T, Mairinger F, et al. Glanduläres Papillom des rechten Hauptbronchus. Pathologe [Internet]. 2013 Jul 22;34(4):338–42. doi: 10.1007/s00292-012-1725-2.
- Abiko T, Koizumi S, Takanami I, Tanaka F. 18F-FDG-PET/CT findings in primary pulmonary mixed squamous cell and glandular papilloma. Ann Nucl Med [Internet]. 2011 Apr 25;25(3):227–9. doi: 10.1007/s12149-010-0454-y.
- Kozu Y, Maniwa T, Ohde Y, Nakajima T. A Solitary Mixed Squamous Cell and Glandular Papilloma of the Lung. Ann Thorac Cardiovasc Surg [Internet]. 2014;20(Supplement):625–8. doi: 10.5761/atcs.cr.13-00029.
- Masunaga A, Oide T, Kamata T, Kou E, Sekine Y, Hiroshima K. GLUT-1 expression of pulmonary mixed squamous cell and glandular papilloma may be associated with high SUVmax on fluorodeoxyglucose-positron emission tomography. Pathol Int [Internet]. 2017 Jul;67(7):373–4. doi: 10.1111/pin.12547.
- INOUE Y, OKA M, ISHII H, KIMINO K, KISHIKAWA M, ITO M, et al. A Solitary Bronchial Papilloma with Malignant Changes. Intern Med [Internet]. 2001;40(1):56–60. doi: 10.2169/internalmedicine.40.56.
- Tanaka R, Emerson LL, Karwande S V., Schreiber G. Growing Pulmonary Nodule With Increased 18-Fluorodeoxyglucose Uptake in a Former Smoker. Chest [Internet]. 2005 May;127(5):1848–51. doi: 10.1378/chest.127.5.1848.
- Emerson LL, Layfield LJ. Solitary peripheral pulmonary papilloma evaluation on frozen section: A potential pitfall for the pathologist. Pathol - Res Pract [Internet]. 2012 Dec;208(12):726–9. doi: 10.1016/j.prp.2012.09.007.
- Wu C-W, Chen A, Huang T-W. Diagnosis and management of glandular papilloma of lung: A case report. World J Clin Cases [Internet]. 2020 Mar 26;8(6):1104–7. doi: 10.12998/wjcc.v8.i6.1104.
- An AR, Park SY, Kim JH, Chae KJ, Chung MJ. Adenocarcinoma-Papillary Cystic Pattern Arising in a Mixed Squamous and Glandular Papilloma of the Lung. Int J Surg Pathol [Internet]. 2020 Sep 25;28(6):658–62. doi: 10.1177/1066896920908330.
Information
Journal history
Keywords
Directories and indexes
Support + Info Here
