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(A) Fiberoptic bronchoscopy examination demonstrating endoluminal growth, with submucosal infiltration with prominent mucosal vascularity causing occlusion of the bronchus intermedius. (B) CT scan of the thorax (mediastinal window section) demonstrating a subcarinal mass (black arrow) with soft tissue opacity in the left main bronchus.
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Introduction
Primary tracheal adenoid cystic carcinoma (ACC) is a rare and heterogeneous group of neoplasms arising from the respiratory tract. The solid variant of ACC is a histologically distinct subtype with an unfavorable clinical course. We report on a case of tracheal ACC with immunohistochemical and molecular analysis together with a review...
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Citations
... MSCT is mainly improved in the scanning rack, detector, data acquisition system (DAS), image reconstruction system, and computer system (15). The isotropic imaging is adopted for musculoskeletal inspection, the special circumstances of multidirectional reconstruction CT angiography of the spinal cord, the large scope and multi-temporal study, CT angiography, cardiac assessment, cerebral perfusion imaging, the examinations of the patients with large size, the evaluation of patients with acute chest pain or shortness of breath, the artificial endoscope, and retrospective image fusion for thin layer scanning (16,17). ...
Objective
it aimed to explore the value of multislice helical computed tomography (MSCT) in the diagnosis and surgical treatment of primary tracheal tumors.
Methods
64 patients with the primary tracheal tumor who were diagnosed in Wuxi Second People’s Hospital from March 2020 to March 2021 were selected as the research objects. MSCT imaging was performed on all patients, and suitable surgical methods. The pathological results were compared with original CT, CT virtual endoscopy (CTVE), and Comparisons were made using CT three-dimensional reconstruction images to evaluate the accuracy of MSCT diagnosis. Parameters such as postoperative complications and survival rates were observed to assess surgical effectiveness and safety.
Results
Compared with original CT images (70%, 72%, 70%), the diagnostic accuracy of VR images (80%, 80%, 80%), MPVR images (85%, 90%, 92%), and CTVE images (100%, 100%, 100%) was remarkably improved (P<0.05). The three-year survival rate of patients with smooth muscle tumors, malignant tumors, salivary gland adenoma, papillary tumors, and inflammatory polyp was markedly lower than that of the one-year survival rate, with a significant difference (P<0.05). The incidence of postoperative complications was 14.1%, with three cases resulting in complication-related deaths.
Conclusion
the diagnostic accuracy of MSCT imaging of primary tracheal tumor was high. The diagnostic accuracy of CTVE was higher than that of VR and MPVR. Besides, surgical treatment of primary tracheal tumor had a substantial effect, with no serious postoperative complications.
... Based on histological features and cellular arrangement, PACC can be classified into three types, including tubular tumor (grade I), sieve-shaped tumor (grade II), and solid-type mass (grade III). 5,6 The cytological examination revealed cells of uniform size and morphology. The samples were characterized by sparse cytoplasm, small nuclei, and deep staining. ...
Background
This study aimed to investigate the clinicopathological features and prognostic indicators of primary pulmonary adenoid cystic carcinoma (PACC).
Methods
Clinical data were collected from 64 primary PACC patients and analyzed retrospectively at the Tianjin Medical University General Hospital, the West China Hospital of Sichuan University, the First Affiliated Hospital of Guangxi Medical University, and the Bishan Hospital of Chongqing Medical University from January 2003 to August 2023. The 64 patients (28 males and 36 females) were aged from 20 to 73 years, with a median age of 49 years and an average age of 49.3 years.
Results
Immunohistochemical staining showed that the tumors expressed CK7, S‐100 protein, CK5/6, CD117, and p63. Seven patients underwent fluorescence in situ hybridization (FISH) testing and three were found to have myeloblastosis (MYB) gene translocation. In total, 53 patients underwent surgery, among whom 31 received only surgery and 22 received both surgery and postoperative chemoradiotherapy. In addition, 10 patients received chemoradiotherapy only, while one patient underwent treatment with traditional Chinese medicine. The overall survival rates in the first, third, and fifth years were 98.4%, 95.3%, and 87.5%, respectively.
Conclusion
Prognostic analysis revealed that age, tumor size, lymph node metastasis status, margin status, and choice of treatment modality significantly influenced the patients' prognosis.
... Microscopically, the tumour tissues show similar sieve and tubular structures, and the tumour cells are small and consistent, with little cytoplasm, an increased ratio of nucleus to cytoplasm, hyperchromatic nuclei, and rare mitosis. Pink-stained basement membrane-like substances can be seen in some lumens, blue-stained mucin-like substances can be seen in some lumens, and both substances can be found in some lumens [5]. Differential diagnoses includes squamous cell carcinoma, carcinoid, mucoepidermoid carcinoma, nonsquamous bronchial carcinoma, lymphoma, etc. [6]. ...
Background:
Primary adenoid cystic carcinoma in the trachea (TACC) is a rare tumour. Tracheal bronchoscopy is always chosen as a routine approach to obtain a pathological diagnosis, but it can be associated with an increased risk of asphyxia.
Case summary:
We describe a case of TACC in a patient evaluated by chest computed tomography (CT) with three-dimensional reconstruction imaging and diagnosed by transoesophageal endoscopic ultrasonography. The pathological diagnosis confirmed tracheal adenoid cystic carcinoma.
Conclusion:
We highlight the importance of CT and provide a successful exploration of transoesophageal biopsy as a safe alternative approach.
... Lesions were also grayish white and the boundaries were unclear, and is mainly composed of ductal epithelial cells and mutated myoepithelial cells [23]. According to the tissue growth pattern of PACC, it can be divided into grade I tubular, grade II cribriform, and grade III solid tumors [17]. Cytological findings include tumor cells that are uniform in size and shape, with scant cytoplasm, and small and hyperchromatic nuclei. ...
... Early-stage PACC patients can achieve satisfactory survival by receiving multimodality therapy. Surgical resection is the main therapy for PACC, and depending on the location and extent of the tumor, the types of surgery may include resection of the trachea, lobectomy, pneumonectomy and segmental resection [17,31]. Local recurrence rates are relatively high in PACC patients with postoperative positive-margins, while endoscopic interventions are an option for palliative treatment in patients Fig. 1 The diagnosis and treatment of PACC who are difficult or unwilling to undergo reoperation after recurrence. ...
Background
Pulmonary adenoid cystic carcinoma (PACC) is an exceptionally rare salivary gland-type malignant neoplasm. Because of its clinical manifestations, imaging features are not different from other types of non-small cell lung cancer, which is a diagnostic challenge for most doctors.
Conclusions
A review of the literature shows that high amounts of immunohistochemical (IHC) markers, such as CK7, CD117, P63, SMA, CK5/6, and S-100 are helpful for PACC diagnosis. Surgical resection is the main treatment of PACC, but treatment options for advanced PACC patients are limited and the research of molecular targeted drugs is ongoing in advanced cases not eligible for surgery. Currently, research on PACC targeted therapy mainly focuses on the exploration of v-myb avian myeloblastosis virus oncogene homolog (MYB) and its downstream target genes. In addition, median tumor mutation burden and PD-1/PD-L1 were lower in PACC, which may indicate poor efficacy of immunotherapy in PACC patients. This review focuses on the pathologic features, molecular characteristics, diagnosis, treatment and prognosis of PACC to establish a comprehensive understanding of PACC.
... Whereas ductal cells display positivity for CK7, EMA, CK5/6 and ckit. 7 Surgery is the main mode of treatment along with radiotherapy. 2 The 5 year survival and 10 year survival rate of patients with tracheal ACC ranges from 52 to 79% and 27 to 51% respectively; the survival being longer in patients with complete resection, negative margins and also in patients who receive adjuvant radiotherapy. ...
Adenoid cystic carcinoma is a chief histologic type of malignancy of minor salivary glands. Primary malignant Tracheal neoplasms are rare <0.1%, with Adenoid Cystic Carcinoma being very rare. It arises from mucous secreting cells of salivary glands and upper respiratory tract. After Squamous Cell Carcinoma it is second most common Primary tracheal malignancy. Diagnosis can be done by Computed Tomography or Magnetic Resonance Imaging. But histopathology remains gold standard of diagnosis.
Primary tracheal adenoid cystic carcinoma (TACC) occurring in the cervical trachea and invading the thyroid is very rare. Surgical resection and airway reconstruction are the main treatment methods, and other treatments include radiotherapy and endoscopic intervention. Herein, we present the case of a 74-year-old female patient with TACC. The patient underwent surgery and postoperative pathology showed that the tumor invaded the adventitia of the trachea and bilateral thyroid, where nerve involvement was observed. The patient recovered well after the operation without adjuvant therapy. Eight months after the operation, Computed tomography showed that the trachea was unobstructed and there was no recurrence.
