Adenoid Cystic Carcinoma of the Airways:Helical CT and Histopathologic Correlation
Seo-Hyun Kwak1,
Kyung Soo Lee1,
Myung Jin Chung1,
Yeon Joo Jeong1,
Gou Young Kim2 and
O Jung Kwon3
1 Department of Radiology and Center for Imaging Science, Samsung Medical
Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong Kangnam-gu,
Seoul 135-710, Korea.
2 Department of Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan
University School of Medicine, Seoul 135-710, Korea.
3 Department of Medicine, Division of Pulmonary and Critical Care Medicine,
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
135-710, Korea.
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Fig. 1A. —Adenoid cystic carcinoma in 33-year-old man. Unenhanced
transaxial CT scan (2.5-mm collimation) obtained at level of thoracic inlet
shows tracheal tumor of irregular contour and broad base with both
intraluminal (arrow) and extraluminal (arrowheads)
components. More than 180° of tracheal circumference is involved.
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Fig. 1B. —Adenoid cystic carcinoma in 33-year-old man. Sagittal
reformatted image (2.5-mm thickness) shows both intraluminal (arrow)
and extraluminal (arrowheads) components of tracheal tumor and
longitudinal extent of lesion.
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Fig. 1C. —Adenoid cystic carcinoma in 33-year-old man. Photomicrograph
of transaxial section of gross specimen shows intraluminal (arrows)
and extraluminal (arrowheads) components of tumor. (H and E,
x1)
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Fig. 2A. —Adenoid cystic carcinoma in 60-year-old man. Unenhanced
transaxial CT scan (3-mm collimation) at level of distal trachea that was
obtained using mediastinal window settings shows lobulated and broad-based
intraluminal soft-tissue tumor (arrow) in anterolateral aspect of
distal trachea. Also note marked wall thickening (arrowheads). More
than 180° of circumference is involved.
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Fig. 2B. —Adenoid cystic carcinoma in 60-year-old man. Coronal
reformatted CT scan (2.5-mm thickness) shows both intraluminal and
extraluminal (arrowheads) growth of tumor. Longitudinal extent of
lesion involving distal trachea (solid arrow) and right main bronchus
(open arrow) is clearly visualized.
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Fig. 2C. —Adenoid cystic carcinoma in 60-year-old man. Photomicrograph
of longitudinal section of gross surgical specimen shows intraluminal
(arrows) and extraluminal (arrowheads) tumor growth
(predominantly, intraluminal growth) with multisegmental involvements of
tracheal cartilage. (H and E, x1)
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Fig. 3A. —Adenoid cystic carcinoma in 41-year-old man. Coronal
reformatted image of enhanced CT scan (2.5-mm thickness) shows soft-tissue
mass (arrow) obliterating right upper lobar bronchus and attendant
atelectasis of right upper lobe (arrowheads).
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Fig. 3B. —Adenoid cystic carcinoma in 41-year-old man. Enhanced
transaxial CT scan (2.5-mm collimation) obtained at level of liver dome shows
metastatic lesions (arrows) in liver. Metastases were proven with
percutaneous liver biopsy.
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Fig. 4A. —Adenoid cystic carcinoma in 40-year-old man. Enhanced
transaxial CT scan (2.5-mm collimation) obtained at level of left inferior
pulmonary veins shows soft-tissue lesion (arrow) encircling bronchus
intermedius. Right lower lobe (arrowhead) is partially
atelectatic.
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Fig. 4B. —Adenoid cystic carcinoma in 40-year-old man. Coronal
reformatted CT image (2.5-mm thickness) shows longitudinal extent of lesion
(arrows) encircling bronchus intermedius. Right lower lobe
(arrowhead) is partially atelectatic.
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Fig. 4C. —Adenoid cystic carcinoma in 40-year-old man. Photomicrograph
of longitudinal section of bronchus intermedius shows intraluminal growth of
tumor (arrows), obliterating distal bronchial lumen of bronchus
intermedius. (H and E, x1)
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Fig. 5A. —Adenoid cystic carcinoma in 43-year-old man. Enhanced
transaxial CT scan (2.5-mm collimation) obtained at level of middle lobe
bronchus shows soft-tissue tumor (arrow) filling lingular segmental
bronchus.
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Fig. 5B. —Adenoid cystic carcinoma in 43-year-old man. Photomicrograph
of transaxial section of gross surgical specimen shows transluminal tumor with
predominantly extraluminal growth pattern (arrows). L = bronchial
lumen. (H and E, x1)
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Fig. 6A. —Adenoid cystic carcinoma in 50-year-old woman. Enhanced
transaxial CT scan (5.0-mm collimation) obtained at level of thyroid glands
shows lobulated and broad-based soft-tissue lesion (arrows) in right
posterolateral portion of trachea with both intraluminal and extraluminal
components. Less than 180° of circumference is involved.
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Fig. 6B. —Adenoid cystic carcinoma in 50-year-old woman. Parasagittal
reformatted CT image (5.0-mm thickness) shows longitudinal extent of lesion
(arrow) mainly located in posterior portion of trachea.
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Fig. 6C. —Adenoid cystic carcinoma in 50-year-old woman.
High-magnification photomicrograph shows sheets of small uniform cells
arranged in classic cribriform growth pattern. (H and E, x100)
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Copyright © 2004 by the American Roentgen Ray Society.
