Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Adenoid cystic carcinoma
- Radiologic Findings
- Fig 1. Chest radiograph shows mass-like increased opacity in mediastinum with thickening of right paratracheal stripe and mild shifting of tracheal lumen to the left side.
Fig 2-4. Low attenuation mass around the trachea, nearly encircling the tracheal circumference. Focal intraluminal protruding lesion at right posterior portion of tracheal lumen (Fig2).
Fig 5. The longitudinal extent of the tumor is greater than its transaxial extent.
Fig 6-9. Mass appears as low signal intensity (SI) on T1 weighted image (WI), high SI on T2 WI and homogenous enhancement. Focal nodular lesion invading intraluminally at the junction of cartilage and posterior membrane is noted, transluminal tumor with intraluminal and extraluminal growth pattern.
Biopsy via ultrasonography at the supraclavicular area revealed adenoid cystic carcinoma.
- Brief Review
- Adenoid cystic carcinoma, which was formerly named cylindroma and adenocystic carcinoma, occurs mainly in the salivary glands or central airways, such as the trachea and the main bronchi. It is a low-grade malignancy that is the second most common tracheal malignancy at histology (33%) after squamous cell carcinoma (48%) (1).
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 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 (2-5).
The longitudinal extent of the tumor is greater than its transaxial extent (2). The tumors usually involve more than 180 of the airway circumference.
Although the most common site of the tumor in the trachea has been reported to be the posterolateral wall, the anterolateral wall
- References
- 1. Li W, Ellerbroek NA, Libshitz HI. Primary malignant tumors of the trachea: a radiologic and clinical study. Cancer 1990;66:894
- Keywords
-
Airway, Neoplasm_Malignant,