Trachea - Adenoid cystic carcinoma

Home Chapter Home Jobs Conferences Fellowships Books

Trachea

Tumors

Adenoid cystic carcinoma

Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 8 February 2013, last major update October 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
=========================================================================

● #2 most common primary malignancy of trachea after squamous cell carcinoma
● Resembles salivary gland tumor

Clinical features
=========================================================================

● Usually in upper third of trachea
● Intramural (15%) or extramural (85%)
● Symptoms: dry cough, dyspnea, hemoptysis
● May coexist with main bronchus lesion
● 20% invade locally (including thyroid gland); may metastasize to lymph nodes, nasal cavity, liver
● Lengthy clinical course, but poor long term prognosis due to late local recurrences
● Median overall surival 18 years, median disease free survival 10 years
● 75% survival rate if complete resection
● Predictors of survival: margin status, extramural disease, perineural invasion, lymph node metastases (Eur J Cardiothorac Surg 2010;37:1438, Ai Zheng 2004;23:581)

Case reports
=========================================================================

● 44 year old woman with midline neck swelling mimicking thyroid tumor (Lung India 2010;27:167)
● 52 year old woman with tracheal primary and liver metastases (Gut Liver 2009;3:127)
● 63 year old woman with metastasis to nasal cavity (Ear Nose Throat J 2009;88:E9)
● 79 year old woman treated with curettage and radiation therapy (South Med J 2011;104:68)
● Metastatic to placenta (Hum Pathol 1989;20:193)

Treatment
=========================================================================

● Chemotherapy, radiotherapy, surgery (Head Neck 2012;34:1263)

Micro description
=========================================================================

● Cribriform growth pattern of nests of tumor cells with discrete, rounded, “punched-out” gland-like spaces filled with eosinophilic or basophilic material
● Infiltrative, perineural invasion common

Micro images
=========================================================================

Uniform hyperchromatic basaloid cells surrounding acellular spaces containing mucoid and hyaline material

Tubular structures with microcysts surrounding hyalinized stroma

Cytology description
=========================================================================

● Rarely extends to thyroid and presents as thyroid nodule (Am J Clin Pathol 2004;121:551)

Cytology images
=========================================================================

Spherical globules of basement membrane material and hyperchromatic uniform rounded tumor cells with scanty cytoplasm (May Grunwald Giemsa stain)

Positive stains
=========================================================================

● Brain derived neurotrophic factor (Hum Pathol 2002;33:933)

Differential diagnosis
=========================================================================

● Thyroid tumor

End of Trachea > Tumors > Adenoid cystic carcinoma

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).