Pulmonary papillary adenoma presenting in central portion: a case report
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CASE REPORT
Open Access
Pulmonary papillary adenoma presenting in central portion: a case report Xu-Yong Lin1,2, Qiang Han1,2, En-Hua Wang1,2 and Yong Zhang1,2*
Abstract Pulmonary papillary adenoma is a very rare tumor usually presenting in periphery of the lung. Herein, we present a case of pulmonary papillary adenoma located in central portion of the lung in a 17 year-old Chinese female. A well-defined mass was incidentally detected at right pulmonary hilar region by imaging examination. Histologically, the tumor is predominantly composed of abundant papillary structures lined by columnar to cuboidal epithelial cells resembling type II pneumocytes. Immunohistochemical staining showed that the epithelial cells were diffusely positive for cytokeratin, cytokeratin7, TTF-1, EMA, surfactant apoprotein A, Napsin A, P63 and β-catenin. The Ki-67 proliferation index was approximately 2 %. Based on morphologic features and the immunohistochemical profile, the tumor was consistent with pulmonary papillary adenoma. Thus, it should be noted that pulmonary papillary adenoma was also a possible diagnosis for a central mass. Keywords: Pulmonary papillary adenoma, Lung tumor
Background Pulmonary papillary adenoma is a very rare tumor that first described by Fantone et al. in 1982 [1]. So far, less than 25 cases were reported in the English literature [2–16]. The reported cases predominatly occurred in periphery of the lung. In contrast, we present a case of pulmonary papillary adenoma located in the central portion of the lung in a 17 year-old Chinese female. This tumor was generally considered benign; however, some scientists thought that it might have malignant potential because of its microinvasive characteristics [9, 10]. The patient was alive with no evidence of tumor recurrence or metastasis within 12 months of follow-up. Case presentation Clinical history
A 17-year-old female without a history of smoking was admitted to our hospital for complaining of a right pulmonary nodule incidentally detected during routine examination. The patient was asymptomatic; physical examination and routine laboratory studies were all within normal values. X-ray demonstrated that there was * Correspondence: [email protected] 1 Department of Pathology, the First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang 110001, China 2 Institute of Pathology and Pathophysiology, China Medical University, Shenyang 110001, China
a well-defined solid mass measuring 3.13 cm in the diameter at the right pulmonary hilar region (Fig.1). In the current visit, the patient underwent wedge resection in our hospital. The postoperative course was uneventful, and there was no evidence of disease 12 months later.
Materials and methods The resected specimens were fixed with 10 % neutralbuffered formalin and embedded in paraffin blocks. Tissue blocks were cut into 4-μm slides, deparaffinized in xylene, rehydrated with graded alcohols, and immunostained with the following antibodies: cytokeratin (CK), cytokeratin7(CK7), CD6
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