Adenoma and Cylindroma of the Bronchus

¹ Departments of Surgery and Otolaryngology, University of Illinois Research and Educational Hospital and St. Luke's Hospital, Chicago, Ill.

Twenty cases of adenoma and two of cylindroma of the bronchus are presented and analyzed according to their history and clinical, x-ray and bronchoscopic findings. The histopathology is discussed to emphasize the differentiation between adenomas and cylindromas. The adenomas are considered as extremely slowly growing but invasive tumors, rather than metastasizing malignant neoplasms, whereas, cylindromas meet all the criteria of malignant lesions.

Choice of therapy was influenced by the location and histologic character of the lesion, the presence or absence of bronchopulmonary changes peripheral to the lesion, the degree of hemorrhage associated with the bronchoscopic procedures, and the response to endobronchial therapy. Of the 20 cases of adenoma, 10 were treated by bronchoscopy alone and 10 by subsequent surgical procedures. Of the former group (bronchoscopic), complete removal was effected in 5, of whom 4 are improved, and 1 was seen for biopsy only and has not been traceable. Of the latter group (surgical), total pneumonectomy was performed in six cases; four are living and well, one improved, and one died postoperatively. Lobectomy was performed in three cases; one is living and well, one improved, and one died postoperatively. The 10th surgically treated patient merely had a thoracotomy with cautery drainage, resection being impossible due to extensive adhesions. In the cylindroma group, one patient was treated bronchoscopically for 5 years merely to keep the tracheal and bronchial airway open since the tumor had involved the entire right bronchus and invaded the trachea at the time of diagnosis. The second patient in this group was treated by immediate pneumonectomy but had a recurrence 5 years later.