1991 Volume 13 Issue 2 Pages 130-138
Bronchial adenocarcinoma showing intraluminal polypoid growth is quite rare. Recently we experienced five such cases. The purpose of this study is to compare the bronchoscopic findings with those of small cell carcinoma manifesting as a protruding mass covered with bronchial mucosa. Five cases of adenocarcinoma and 10 of small cell carcinoma were examined. Bronchoscopic findings were reviewed with respect to the appearance and color of the tumor surface, submucosal vessels, the site of the tumor, the relation between the tumor and the surrounding bronchial wall and the appearance of the surrounding bronchial wall. All of the polypoid adenocarcinomas had smooth, normal colored surface identical to the adjacent bronchial wall. No case showed abnormal subepithelial vessels. Submucosal patchyhemorrhage was seen in 4 cases, at the segmental or more peripheral bronchi and occluded them completely. The surrounding bronchial wall appeared normal in 4 cases. However, the protruding masses of small cell carcinoma, on the contrary, had an irregular reddish colored surface. Dilated tortuous submucosal vessels were seen in all cases in segmental or more proximal bronchi. Most of the tumors had a broad base and showed eccentric growth in the bronchial lumen. In 8 cases, the surrounding bronchial wall revealed reddness, suggesting submucosal tumor extension. These bronchoscopic findings are likely to be of help in differentiating these two entities.
