대한흉부영상의학회 Weekly Chest Cases

Case No : 804 Date 2013-03-25

Courtesy of Kyung Won Doo, Eun-Young Kang, Hwan Seok Yong / Korea University Guro Hospital
Age/Sex 21 / F
Chief ComplaintCough and sputum for 1 month

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Diagnosis With Brief Discussion

Diagnosis: Adenoid cystic carcinoma
Radiologic Findings: CT images show endobronchial mass obstructing left main bronchus with peribronchial soft tissue thickening at left main bronchus, carina, extending to left lower tracheal wall, with mucous collection in distal lobar bronchus.
Brief Review: Adenoid cystic carcinomas are usually recognized without sex predilection in patients in their 40s, and smoking does not affect the incidence. It is a low-grade malignancy that is the second most common tracheal malignancy at histology (33%) after squamous cell carcinoma (48%). Adenoid cystic carcinomas usually arise in the lower trachea. Others are found in the mainstem bronchi, lobar bronchi or, rarely, in the segmental bronchi and extrathoracic trachea. The most common site of the tumor in the trachea has been reported to be the posterolateral wall.
On CT, the tumor has a striking tendency toward submucosal extension that manifests as an intraluminal mass of soft tissue attenuation with extension through the tracheal wall, a diffuse or circumferential wall thickening of the trachea, a soft tissue mass filling the airway, or a homogeneous mass encircling the trachea with wall thickening in the transverse and longitudinal planes. The longitudinal extent of the tumor is greater than its transaxial extent. It shows better prognosis than squamous cell carcinoma (5yr survival; 65-100%) and relatively common late recurrence after surgery.
Please refer to
References: Adenoid Cystic Carcinoma of the Airways: Helical CT and Histopathologic Correlation, Seo-Hyun Kwak et al., AJR 2004;183:273-281
Keywords: Airway, Malignant tumor,

No. of Applicants : 89

▶ Correct Answer : 6/89, 6.7%

- Korea university anam hospital , Korea (South) Sung-Hye You
- Ishikawa Matto Central Hospital , Japan Manabu Akimoto
- Hanyang University Hospital , Korea (South) Yo Won Choi
- Kyoto University , Japan Akihiko Sakata
- IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
- Fukuyama city hospital , Japan Mayu Uka

▶ Correct Answer as Differential Diagnosis : 20/89, 22.5%

- Oita University, Faculty of Medicine , Japan Fumito Okada
- Kyung Hee University Hospital at Gangdong , Korea (South) Seong Jong Yun
- Nagasaki University Hospital, Department of Pathology , Japan TOMONORI TANAKA
- IRSA La Rochelle France , France Denis Chabassiere
- jaslok hospital & research centre mumbai , India JAINENDRA JAIN
- CNUH , Korea (South) Kim Hyun
- Kobe City Medical Center General Hospital , Japan Yasuhisa Kurata
- Osaka university , Japan Akio Tsukabe
- Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
- Asan Medical Center , Korea (South) Hye Jeon Hwang
- SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OOKUBO
- Onomichi Municipal Hospital , Japan Yoshihisa Masaoka
- Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
- clinique de SAVOIE , France, Metropolitan gay-depassier philippe
- Medicheck health care , Korea (South) Chae Lim
- CAC Rennes , France nicolas gautier
- Onomichi municipal hospital , Japan Hirofumi Mifune
- All India Institute of medical sciences , India Justin Moses
- Shiga University of Medical Science , Japan Akitoshi Inoue
- All India Institute of Medical Sciences , India Ashish Gupta

▶ Semi-Correct Answer : 4/89, 4.5%

- NIMS, HYDERABAD , India bhaskar kakarla
- Chernomorska , Bulgaria VLADISLAV RUSINOV
- GHICL , France manuel toledano
- Eren T캇p Merkezi Istanbul , Turkey Armagan Sarac

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 804 Date 2013-03-25

Discussion

No. of Applicants : 89