Benign Tumors of the Lungs with Special Reference to Adenomatous Bronchial Tumors

¹ The Thoracic Surgical Services of Cedars of Lebanon Hospital, Los Angeles; Los Angeles County General Hospital, Harbor Branch, Torrance; Birmingham Veterans Hospital, Van Nuys; Departments of Pathology and Thoracic Surgery, University of California Medical School, San Francisco, California.

1) Thirty-eight cases of adenomatous bronchial tumors are briefly reported.

2) So-called benign tumors of the lung and bronchi are most frequently adenomatous bronchial tumors.

3) Adenomatous bronchial tumors are a group of several histologic variants, the most common of which are the carcinoid, mixed tumor and cylindromatous types. Glandular and myoepithelial types occur.

4) These tumors are extremely important because on the one hand they represent potential malignant tumors and on the other clinically curable tumors.

5) They produce symptoms and often death largely through pulmonary suppuration resulting from bronchial obstruction but also they are prone to serious hemorrhages. They may after many years metastasize and even produce death associated with metastases.

6) Bronchoscopy is always indicated for biopsy of the tumor and in approximately 90 per cent the tumor is accessible to bronchoscopic biopsy because of its location in a lobar or stem bronchus.

7) The Ideal treatment is removal of the tumor with lobectomy or pneumonectomy. Twenty-three of the 38 patients in this series had surgical resection therapy: 21 were lobectomy or pneumonectomy; two were resected via transpleural bronchotomy (Case 35, Figs. 6, 18, 19 and Case 34, Figs. 8, 20, 21); one had lobectomy plus bronchotomy (Case 15, A.B.); and one had plastic bronchotomy only (Case 33, E.S.).

8) The remainder of the benign bronchial and pulmonary tumors occur infrequently and represent a clinically unimportant group but like all polypoid tumors of the bronchi even though of small size they may produce serious clinical manifestations.