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Wednesday, March 2, 2011

BRONCHIAL ADENOMA

This is an uncommon tumour occurring in a younger age group than carcinoma and affecting equally females and males.
 Although classified as a benign tumour it possesses some of the properties of a malignant growth and may eventually metastasise. There are two histological types of bronchial adenoma, the relatively more common bronchial carcinoid and the rare cylindroma (adenoid cystic carcinoma) which often arises at the tracheal bifurcation.
Clinical feature
A bronchial adenoma may produce symptoms over several years. Recurrent haemoptysis due to the vascularity of tumour is common as is recurrent bronchopulmonary infection distal to bronchial obstruction caused by the adenoma. Very rarely, and usually when metastatic spread has occurred, the bronchial adenoma may give rise to the carcinoid syndrome. The physical signs are usually those of collapse. The tumour may be suspected if the patient is  young and symptoms have been present over a prolonged periods; but confirmation of the diagnosis can only be made by bronchoscopy, biopsy and histology.
Management
Treatment is by resection of the pulmonary lobe or segment containing the tumour along with the bronchus from which it arises. Occasionally when surgical resection is not possible local removal of tumour tissue from the bronchial lumen or laser therapy may be an alternative.

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