대한흉부영상의학회 Weekly Chest Cases

Case No : 1360 Date 2023-11-14

Courtesy of Dabee Lee, Kye Ho Lee, MD. / Dankook University Hospital
Age/Sex 64 / M
Chief Complaintabnormal imaging on routine health check

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Diagnosis With Brief Discussion

Diagnosis: Mucoepidermoid carcinoma
Radiologic Findings: Figs 1. Chest PA shows nodular opacity overlying the right main bronchus.
Fig 2-3. Mediastinal window setting of the chest CT scan shows an intraluminal polypoid nodule abutting the right main bronchus, anterior wall.
Figs 4. Bronchoscopy.
Brief Review: Second most common form of tracheobronchial gland neoplasm but accounts for less than 0.2% of pulmonary carcinomas.
Half are younger than 30 years.
Most commonly involves segmental bronchi > lobar or main bronchi or trachea
Sx: cough, hemoptysis, recurrent pneumonia, and dyspnea (related predominantly to growth in the airway wall and lumen)
Classification:
- Low grade: young female, often are confined to the bronchial wall, low FDG uptake, central nodule, or mass may suggest low-grade PMECs
- High grade: aged >40 years, commonly extends into the peribronchial interstitium or adjacent lung parenchyma, metastases, high FDG uptake
Imaging findings: related to tumor location and size
- smoothly oval or lobulated soft tissue nodule or mass
- polypoid intraluminal nodule in tracheobronchial tree
- Punctate calcification (25-50%)
- homogeneous and show slight enhancement
- distal obstructive pneumonitis, atelectasis, or air-trapping
References: 1. Cheng DL, Hu YX, Hu PQ, Wen G, Liu K. Clinicopathological and multisection CT features of primary pulmonary mucoepidermoid carcinoma. Clin Radiol 2017;72:610.e611-610.e617. doi:10.1016/j.crad.2017.02.007.
2. Muller's Imaging of the Chest, 2nd edition.
Keywords

No. of Applicants : 72

▶ Correct Answer : 5/72, 6.9%

- , China FANG YING GEN
- , Japan YUKIKO USUI
- Mie university , Japan SHIKO OKABE
- TB centre kasaragod. , India rikhy krishnan
- The University of Tokyo Hospital , Japan HIROSHI TAKUMIDA

▶ Correct Answer as Differential Diagnosis : 23/72, 31.9%

- , Japan SUZUNE TSUKAMOTO
- The University of Tokyo Hospital , Japan JUN KANZAWA
- , Japan KYOKO NAGAI
- Shiga University of Medical Science , Japan AKITOSHI INOUE
- McGill University Health Center , Canada ALEXANDRE SEMIONOV
- Oita university , Japan AYUMI KAMEI
- Healthy Longevity Medical Center , Japan SHIN-ICHI CHO
- Vita Hospital , Brazil DIOGO LAGO PINHEIRO
- Oita University, Faculty of Medicine , Japan FUMITO OKADA
- The University of Tokyo Hospital , Japan WATARU GONOI
- Yokkaichi municipal hospital , Japan HIKARI FUKUI
- Soonchunhyang University Hospital Bucheon , Korea (South) HYEJOO PARK
- , Japan KENTARO KOTANI
- Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
- , Japan SHUNJIRO NOGUCHI
- Tokyo Medical and Dental University , Japan MIKIYA FUJII
- Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
- Fukuoka university , Japan KEISUKE SATO
- Nerimahikarigaoka hospital , Japan TAKANA HAYASHI
- Matsunami General Hospital , Japan TARO TAKEDA
- Toyota Kosei Hospital , Japan YUKI HAYASHI
- the first affiliatited hospital of nanjing medical univercity , China HAI XU
- , Korea (South) JIN WOO YOON

▶ Semi-Correct Answer : 1/72, 1.4%

- GHICL , France MANUEL TOLEDANO

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 1360 Date 2023-11-14

Discussion

No. of Applicants : 72