대한흉부영상의학회 Weekly Chest Cases

Case No : 483 Date 2007-01-29

Courtesy of Jin Kong Yong, MD. / Chonbuk National University Hospital, Korea.
Age/Sex 18 /
Chief ComplaintHemoptysis during three days

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Diagnosis With Brief Discussion

Diagnosis: Plain chest radiograph shows bulging contour-soft tissue lesion at left suprahilar area. Neck CT shows left vocal cord palsy. Chest CT shows two saccular aneurysms at isthmic portion of aortic arch.
Radiologic Findings: Chest PA showed no active pulmonary parenchymal lesions except prominent vascular shadow in LLLF. A polyphoid lesion is visible in the left lobar bronchus on pre-contrast CT. On contrast-enhanced CT, this mass showed heterogeneous enhancement. PET/CT showed hyper metabolic mass in LLL. Microscopic finding of surgical specimen showed aggregates of squamous cell carcinoma in a mucoid background.
Differential diagnosis: Adenoid cystic carcinoma, adenocarcinoma, pulmonary hamatoma, carcinoid tumor
Brief Review: This is a rare salivary gland tumor, which arises in lobar or segmental bronchi. The average age at diagnosis is 35 to 45. It tends to exhibit a more benign course than adenoid cystic carcinoma or carcinoid tumor, but high-grade mucoepidermoid carcinoma has been reported to have a poor prognosis. This tumor commonly presents as a solitary central mass with post obstructive atelectasis or pneumonitis on radiologic findings. This tumor, also, show oval, polyphoid or lobulated with well-defined margins and calcifications present in 50%. Surgery is usually curative.
References: 1. Webb WR, Higgins CB. Thoracic imaging: pulmonary and cardiovascular radiology. Lippincot Williams& Wilkins 2005: 104
2. Vogelberg C, Mohr B, Fitze G, Friedrich K, Hahn G, Roesner D et al. Mucoepidermoid carcinoma as an unusual cause for recurrent respiratory infection s in child. J Pediatr Hematol Oncol 2005; 27:162-165
3. Bashar MA, Sadeque AS, Bhuiyan MA, Uddin MN, Hossain MI. Mucoepidermoid carcinoma of the lung ?a case report. Banglandesh Med Res Counc Bull 2003;29:125-129
Keywords: Airway, Malignant tumor,

No. of Applicants : 51

▶ Correct Answer : 3/51, 5.9%

- Hangang Sacred Heart Hospital, Korea Eil Seong Lee
- Samcheonpo JeilHospital, Korea SuJin Kang
- China Medical University Hospital, Taiwan Jun-Jun Yeh

▶ Correct Answer as Differential Diagnosis : 11/51, 21.6%

- Pgimer, Chandigarh, India Ram Prakash Galwa
- Inje University Ilsan Paik Hospital, Korea Bae Geun Oh
- Irsa, La Rochelle, France Denis Chabassiere
- A.S.C.S. Safwa, Saudi Arabia K.Adi Narayana
- Annemasse, Polyclinique De Savoie, France Gay6depassier Philippe
- Monaldi Hospital,Naples, Italy Gaetano Rea
- Yonsei University, Severance Hospital, Korea Hye Ryoung Koo
- Yonsei University, Severance Hospital, Korea Jeong Ho Kang
- Hospital "Sotiria", Athens, Greece VasiliosTzilas
- Annecy Hospital, France Gilles Genin
- Asan Medical Center, Korea Eun Jin Chae

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 483 Date 2007-01-29

Discussion

No. of Applicants : 51