대한흉부영상의학회 Weekly Chest Cases

Case No : 1458 Date 2025-09-29

Courtesy of Geewon Lee / Pusan National University Hospital
Age/Sex 72 / M
Chief ComplaintAbnormal finding at screening CT

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Diagnosis With Brief Discussion

Diagnosis: Mucoepidermoid carcinoma
Radiologic Findings: Fig 1. Chest PA shows fibrotic bands at both upper lung zones, suggesting old infection sequelae
Fig 2, 3. Postcontrast axial and coronal chest CT scans show a small intraluminal nodule located at the anterior wall of lower trachea with enhancement.
Fig 4. Bronchoscopy shows a mass at the lower trachea.
Brief Review: Bronchoscopic biopsy was performed and a histopathologic diagnosis of intermediate grade mucoepidermoid carcinoma was made.
Mucoepidermoid carcinoma of the tracheobronchial tree is a rare airway tumor, composing only 0.1%–0.2% of the primary lung malignancies. Mucoepidermoid carcinoma is defined as a malignant epithelial tumor consisting of squamoid cells, mucin-secreting cells and intermediate cells.
Reported radiographic findings of the bronchial mucoepidermoid carcinoma consist of a solitary nodule or a mass with or without findings of postobstructive pneumonia or atelectasis. Tracheal mucoepidermoid carcinoma may be seen as a localized endoluminal mass contrasting with the surrounding endoluminal air column.
Surgical resection is the mainstay of treatment, and usually carries good prognosis. Low-grade malignant tumors of the bronchial airway are often managed with open resection. High-grade mucoepidermoid carcinoma carries a higher risk of distant metastasis and worse prognosis even with surgery
References: 1. Kim TS et al. Mucoepidermoid carcinoma of the tracheobronchial tree: radiographic and CT findings in 12 patients. Radiology 1999;212:643-648
2. Ha SY et al. Mucoepidermoid Carcinoma of Tracheobronchial Tree: Clinicopathological Study of 31 Cases. The Korean Journal of Pathology 2011;45:175-181
3. Li X et al. CT features and differential diagnosis of primary pulmonary mucoepidermoid carcinoma and pulmonary adenoid cystic carcinoma., J Thorac Dis. 2018;10:6501–6508
Keywords

No. of Applicants : 76

▶ Correct Answer : 2/76, 2.6%

- , China FANG YING GEN
- GHICL , France MANUEL TOLEDANO

▶ Correct Answer as Differential Diagnosis : 27/76, 35.5%

- , Japan SUZUNE TSUKAMOTO
- Shiga University of Medical Science , Japan AKITOSHI INOUE
- Kyoto University , Japan AKIHIKO SAKATA
- Oita university , Japan AYUMI KAMEI
- , Korea (South) KYUNG HYUN WOO
- Kyeongpook National University Hospital , Korea (South) JUNGMIN LEE
- Oita University, Faculty of Medicine , Japan FUMITO OKADA
- The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
- , Japan YOSHIKI ISHII
- Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
- Japanese Red Cross Otsu Hospital , Japan JUN YOSHIDA
- Oita university , Japan NORITAKA KAMEI
- , Korea (South) HYOUNG YEOB KIM
- Other , Korea (South) CHAEHUN LIM
- , Japan SHUNJIRO NOGUCHI
- , Japan MASAMICHI IWAI
- University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
- Shiga General Hospital , Japan YUSAKU MORIBATA
- Osaka metropolitan university Hospital , Japan TATSUSHI OURA
- The First Affiliated Hospital of Nanjing Medical University , China TENG ZHANG
- Kyoto University , Japan SHO KOYASU
- Kyung Hee University Medical Hospital , Korea (South) JEONG TAEK YOON
- Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
- Ehime University , Japan KOTARO MATSUMOTO
- Toyota Kosei Hospital , Japan YUKI HAYASHI
- the first affiliatited hospital of nanjing medical univercity , China HAI XU
- University of Yamanashi , Japan KOJIRO ONOHARA

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 1458 Date 2025-09-29

Discussion

No. of Applicants : 76