Alveolar Adenoma: A 20-Year Experience at a Western Balkan University Hospital and a Literature Review

Int J Surg Pathol. 2023 Oct 29:10668969231204998. doi: 10.1177/10668969231204998. Online ahead of print.

Abstract

Alveolar adenoma is a rare benign lung tumor. We report 5 patients within a 20-year period diagnosed with this rare tumor and its clinical and histopathological features, in order to emphasize its significance in differential diagnosis of other lung tumors. Alveolar adenoma was more frequently diagnosed in female patients (80%). The patients ranged in age from 52 to 68. Eighty percent of the patients had symptoms like dyspnea, and shoulder or back pain. Three patients underwent a video-assisted thoracoscopic surgery, while 2 patients underwent a thoracotomy in order to remove the tumor. The tumor was localized within the right upper lobe, right lower lobe, and left lower lobe in 40%, 40%, and 20% of patients, respectively. The tumor size ranged from 14 to 30 mm. A frozen section finding of all 5 tumors reported that the lesion was benign. In all analyzed tumors, immunohistochemical analysis showed positive expression of TTF-1 and pankeratin in surface epithelial cells, and Vimentin positivity and TTF-1 and pankeratin negativity in round stromal cells. Alveolar adenoma should be carefully considered in the differential diagnosis of solitary pulmonary nodules. Complete surgical removal of the lesion is widely used in its primary management.

Keywords: alveolar adenoma; immunohistochemistry; solitary pumonary nodule; thoracic surgery.