Tuberc Respir Dis.  2013 Jun;74(6):280-285.

A Case of Atypical Adenomatous Hyperplasia of Larger Than 2 cm

• Park BM
• Cho MJ
• Lee HS
• Park DI
• Park MR
• Kim JO
• Lee JE
• Lee CS
• Jung SS

Abstract

Atypical adenomatous hyperplasia (AAH) has been considered to be a precursor lesion of bronchioloalveolar carcinoma (BAC) and pulmonary adenocarcinoma. It usually coexists with BAC and/or an adenocarcinoma. Chest computed tomography reveals multiple well-defined nodules with ground-glass opacity. Usually, AAH does not exceed 10 mm in size. AAH with extensive involvement on one side of the lung field or one that is larger than 2 cm has not been previously reported. We herein report a case of a 71-year-old nonsmoking female with lung AAH of larger than 2 cm.

Keyword

Lung; Precancerous Conditions; Adenocarcinoma

MeSH Terms

Adenocarcinoma
Adenocarcinoma, Bronchiolo-Alveolar
Female
Humans
Hyperplasia
Lung
Precancerous Conditions
Thorax

Figure

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  Figure 1 Chest posteroanterior (PA) view and chest computed tomography (CT). (A) Chest PA on first admission. Patient revisited for aggravation of dyspnea on exertion. Widening of haziness in the right lower lung field and aggravation of linear infiltration in the left middle lung field were shown. (B-D) Chest CT on first admission. Airspace consolidation in the right lung and lingular division of the left upper lobe were shown on the CT. Collapse of the right middle lobe and right lower lobe was noted. Multiple variably sized nodules, some well-defined and some ill-defined, with patchy consolidation and ground-glass opacity (GGO) are present in both the upper lobe and left lower lobe (LLL). (E) Chest PA on second admission. (F-H) Improvement of consolidation in the right lung field, but increased extent of GGO in the right upper lobe and LLL were noted on chest CT at the second admission.

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  Figure 2 Pathologic findings of the surgical lung biopsy specimen and microscopic findings upon hematoxylin and eosin staining. (A) Overall fibrosis and focal atypical alveolar epithelium are noted. (B) Atypical alveolar epithelium (arrows). (C) Magnified atypical alveolar epithelium. (D) Transition area from normal to atypical alveolar epithelium (arrows).

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  Figure 3 Increased glucose metabolism in the right middle and lower lung zones and lateral and posterobasal segment of the left lower lobe are shown using positron emission tomography-computed tomography.

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  Figure 4 Chest radiograph in 17 days after gefitinib treatment.

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