Tumors of the bronchi

The tumor. In the bronchi are developing both benign and malignant tumors. Malignant tumors are different forms of bronchial cancer of the lungs (see the Light). Benign tumors are presented mainly by adenomas. Other types of benign tumors - handsome, leiomyoma and others - are very rare and some of them (handsome), in all probability, are hamartoma, and not to the true tumors. Benign tumors are rarely malignant and approximately 5-10% of the total tumor diseases of bronchi and lungs. Lifetime they are recognized by bronchoscopy combined with biopsy in 99% of cases.
Pathological anatomy. Adenomas of the bronchi are the nodes of round shape with an average diameter. 2-2,5 see Adenomas of large size are rare. Adenomas B., unlike B. cancer, occur in people younger and any difference in the frequency of their occurrence in men and women is not observed. The preferential localization adenomas - proximal and chief B. the right lung. The direction of tumor growth mainly endobronchial that determines the clinical course - obturation of bronchi with its consequences: atelectasis, chronic purulent pneumonia with abscess, bronchiectasis, pneumosclerosis. When extra-bronchial and internal-lung growth of the disease for a long time remains asymptomatic. Surface adenomas smooth color on the cut - whitish or grayish-pink. Necrosis is missing.
From the point of view of micro-morphology, the term "bronchial adenoma" - the collective, including tumors of various structure and cellular structure, therefore, in the literature there are more than 30 synonyms in their designation. The most common option is adenoma carcinoid type (or so-called carcinoid B.). The identification of this species with the carcinoids (see) of the intestine due to morphological similarity with the latter. Adenoma carcinoid type consists of cells of various sizes, mostly small, with delicate fine-grained cytoplasm, where during the impregnation silver found argyrophylla grain, similar to that in the cells typical of carcinoids. Cells are grouped in the field, strands and Islands, separated fibrous layers with a characteristic group of cells around a thin vascular sinusoids and reminiscent of acinar and glandular structure. Occasionally there are mitoses. A large number of vessels in the center of the tumor determines its tendency to haemorrhage. Tumor surface is covered with a cylindrical or a thin layer of metaplastic squamous epithelium on the basal membrane. With the sea wall bronchus she usually strongly related and in some cases penetrates deep into the wall B. and even in peribronchial fabric. In the fabric of adenoma often included particles of bone tissue, the mechanism of formation of which remains outstanding (possible bone transformation of capsules, and soaking fabrics-mukoproteidov with subsequent calcification and ossification). It is assumed that adenomas bronchial carcinoid type, as carcinoids of the intestine, contains serotonin; high content of zinc inherent insular authority. According to some data, extract carcinoids B. causing spastic effect. These tumors may be accompanied by vegetative disorders, dizziness, a sense of heat, astmatoidnogo attacks, allergic and other dermatophytiae
Less common variant of bronchial adenomas are cilindrata (see) and mucosectomy adenoma. Histologically, the latter consists of ferrous pipes and cysts, covered by a cylindrical epithelium and containing acidophilic a homogeneous mass, increased muccicarmine.
On the question of the histogenesis of bronchial adenomas, is not clear. Source adenomas carcinoid type are considered special argentophile cells of the mucous membrane, having regard to the chemoreceptors, which explains the number of histo-chemical properties of these tumors and functional abnormalities observed in them.
Another source of adenomas believe embryonic border mucosa epithelial B., duct epithelium and mucous glands.
Metastases, as a rule, bronchial adenomas not give (with few exceptions), although nodules and cells can be found in nearby lymph nodes.
Typical clinical picture adenomas B. does not have, even in the literature there is the concept of "syndrome of adenoma," characterized by the young age of the patients, re hemoptysis fresh blood without admixture of pus, phenomena bregostenas, lasting.
Treatment of benign tumors of the bronchi surgical (see the Light).
Cm. also Bronchial fistula, Bronchitis, Bronchogenic, Bronhoektatical disease.