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Background and objective
Intratumoral administration of chemotherapeutic agents is a treatment modality that has proven efficacious in reducing the recurrence of tumours and increases specificity of treatment while minimizing systemic side effects. Direct intratumoral injection of malignant airway obstruction has potential therapeutic benefits but tissue drug concentrations and side‐effect profiles...
Metastatic tumors to the lung are extremely common. In fact, the lung ranks number one in terms of organs harboring metastatic diseases. Lung involvement in some autopsy series cite pulmonary involvement in up to 54% of the cases. Factors accounting for the high number of metastasis to the lungs include their rich capillary network and possibly a favorable “seed and soil” disposition inherent to pulmonary...
This tumor is a tumor of bronchial (“salivary”) gland derivation made of varying proportions of squamous cells, mucin-producing glandular cells, and intermediate cells. The major airways are usually involved but some tumors may be intraparenchymal. The age distribution is wide but generally favors the young, with no clear gender predilection. The symptoms are closely related to any degree of airway...
Chondromas are tumors of the lung and the airways which are made entirely of benign cartilage and by definition, lacking entirely of fat, muscle, or bone. Their true frequency is not known since hamartomas with major cartilaginous components are likely to have been misclassified in the past as chondromas. In addition to the lung, they occur in the larynx, trachea, and major bronchi. Primary chondrosarcomas...
Under the name “Uncommon Endobronchial Surface Tumors,” we consider generally benign epithelial proliferations of the trachea and bronchi whose common denominator is a papillary growth pattern. Currently, the World Health Organization recognizes three major histopathologic types: squamous, glandular, and mixed-type papillomas.
Formerly believed to be mesotheliomas, localized or solitary fibrous tumors (LFTs) are rare tumors, most common in the pleura but also reported to involve the lung and other parts of the body. Patients with LFTs are usually middle aged but the overall age distribution is wide. Digital clubbing and pleural effusions may be seen. Their size is quite variable ranging from 1 to 2 cm to masses filling...
Currently, adenocarcinoma ranks as the number one type of major lung cancer, constituting a significant proportion of all of the non-small cell lung cancers. In contrast to small cell and squamous cell lung cancers which are centrally located, most adenocarcinomas are peripheral, subpleural in location. The few that are central may be visualized endoscopically as endobronchial polyoid masses. Radiographically,...
This carcinoma represents about 10% of all lung cancers. Microscopically, its main feature is the high level of malignancy and lack of squamous or glandular features. However, on electron microscopy, features of either adenocarcinoma or squamous cell can be appreciated suggesting that large cell carcinomas are basically poorly differentiated adenocarcinomas or squamous cell carcinomas. Nonetheless,...
A major type of non-small cell lung cancer, squamous cell carcinoma was for many years the leading cell type in terms of frequency. Currently, it ranks second to adenocarcinoma but remains a major cause of morbidity and mortality. As is the case with small cell cancers, squamous cell carcinomas are centrally located, near the hilum and prone to present with hemoptysis and/or early symptoms related...
Small cell carcinomas are highly malignant tumors composed of relatively small uniform cells with scant cytoplasm and stippled nuclear chromatin pattern. An ultrastructural hallmark of these tumors is the presence of membrane-bound, electron-dense granules that contain a variety of active peptide moieties. Small cell carcinomas occur in middle age and older individuals with a mean age of 59 years...
Hamartomas are benign mesenchymal neoplasms containing tissues made up of cartilage, smooth muscle, and connective tissue. They occur in the trachea, bronchi, and the lung parenchymal tissues and are said to be the most common benign tumors of the lung. Hamartomas, particularly the intraparenchymal variants, are clinically silent in the majority of cases. However, the endobronchial ones present with...
This unique vascular tumor is not exclusive to the lung. It can also be seen in liver, bone, pleura, and other anatomical sites. Its prognosis is unpredictable with life expectancies ranging widely from 1 to 15 years after diagnosis. Epithelioid hemangioendothelioma (EHE) has a distinct predilection for younger females, with 80% of cases occurring in women, before the age of 40. Typically, multiple...
A highly distinctive malignant tumor arising from tracheobronchial glands, adenoid cystic carcinoma is characterized by tubular, cribriform, and solid histopathologic patterns and a propensity for extension along perineural spaces. Asthma-like manifestations with wheezing as a prominent sign can be seen in proximally located lesions. Ulceration of the overlying mucosa may result in blood-tinged sputum...
The high-grade non-Hodgkin lymphoma is characterized by a diffuse proliferation of large neoplastic B cells, typically showing nuclear size equal to or greater than the size of a normal macrophage. It is the second most common pulmonary lymphoma after maltoma. It occurs in a wide age range from children to adults. Patients are usually symptomatic. Grossly, the lesions are nodular in configuration...
Primarily occurring in the airways, carcinoids tumors may also arise peripherally within the lung. Their histopathologic hallmark is a growth pattern that suggests neuroendocrine differentiation (organoid, trabecular, insular, etc.). Two major variants of carcinoid tumors are recognized: typical and atypical. Some carcinoid tumors, particularly the ones that are peripherally located, may be clinically...
Sarcomatoid carcinomas are currently listed separately by the WHO as a distinct category of malignant lung tumors. This group of carcinomas encompass some epithelial pseudo sarcomatous carcinomas as well as tumors with true sarcomatous components such as carcinosarcoma. In this atlas we cover two variants of sarcomatoid carcinoma: Giant Cell Carcinoma and Spindle Cell Carcinoma. Both known to be fast...
It has been 25 years since the first reports on endoscopic ultrasonography (EUS) began to appear in the medical literature. The technology involves placing an ultrasound transducer at the tip of an endoscope, which allows for ultrasound imaging to be performed from within the gastrointestinal (GI) lumen. It became quickly apparent that for purposes of thoracic applications and cancer staging that...
Atlas of Neoplastic Pulmonary Disease: Pathology, Cytology, Endoscopy and Radiology is a unique atlas that provides images from four major disciplines involved in the study and diagnosis of lung tumors. This atlas, containing 41 chapters represents a wide range of neoplastic lung entities and will be a quick and reliable interdisciplinary tool for the practitioner involved in the management of...
When a long segment of trachea is resected and grafted with a bioabsorbable scaffold, chronic contraction of the graft occurs, leading to substantial delayed native tracheal axial approximation. This phenomenon may allow for safe two-stage end-to-end tracheal reconstruction of large tracheal defects. We performed this trial to confirm that delayed tracheal axial approximation occurs in a mature animal...
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