Bronchial Cytology of Tracheal Adenoid Cystic Carcinoma — A Case Report

Abstract

Adenoid cystic carcinoma of the trachea is very rare. Articles that include cytological descriptions are even rarer. We wish to present a case report that includes the bronchial cytology for such a carcinoma. We present the case report of a 31-year-old male patient suffering from adenoid cystic carcinoma arising in the left main bronchus. It was initially suspected from bronchial washing cytology. Magenta globules composed of basement membrane material surrounded by small malignant cells were present in the cytological findings. Adenoid cystic carcinoma was considered. Subsequent histopathological diagnosis confirmed our suspicions. Chest computed tomography (CT) showed a hypodense soft tissue mass-like lesion around the left main bronchus with airway stenosis and left lung atelectasis. Surgery and radiation therapy were refused by the patient; he chose to take herbal medication instead. After 18 months follow up, the tumor showed enlargement and the left lung showed total atelectasis. The patient is still alive. Radical surgical resection should not be performed based solely on cytological studies because of resemblance to several benign neoplasms, such as basal cell adenoma or pleomorphic adenoma. Further careful histopathological and immunological studies can often distinguish between these tumors.