Co-existence of bronchial adenoma with pulmonary tuberculosis; a case report.

In the past 20 years, there has been an increasing amount of information forwarded regarding the tumor generally known as bronchial adenoma. Much has been said regarding their classification and nomenclature. Out of many names, those of cylindroma and carcinoid emerge as those in common usage to denote histologic types of bronchial adenoma. There are those who would stress the differences between the two types as being more than based on differences of histologic appearance. Enterline and Schoenberg’ point out that cylindroma causes death or tends to recur seven times as frequently as the carcinoid type. They also feel that cylindroma occurring in the tracheobronchial tree is identical with those tumors arising from salivary glands and ducts, paranasal sinuses and palate, and when occurring in these sites, they are called carcinoma. On the other hand, Davey and Hardy2 feel that cylindroma only superficially resembles the above-mentioned tumors in the salivary glands, paranasal sinuses and palate, and, that certain histologic changes that do occur in them, are not present in cylindroma. For the purpose of this report, it is our belief that Doty’s3 point of view is the most practical. That is, it is of little practical importance to stress the difference in these two types of this tracheobnonchial tumor, since each type gives the same clinical picture, each can be locally invasive and even distantly metastasizing, thereby necessitating the same therapeutic approach. What is generally agreed upon is that it is more common in women than in men, and that in at least 50 pen cent of the cases, it occurs in patients below thirty years of age. It is slow-growing. The duration of symptoms before a diagnosis was made in a series analyzed by Herbut4 was from two to eight years. Moensch and Harrington,5 in a summary point out that symptoms produced depend on the location, size of the tumor, and the characteristically easy bleeding of these tumors. Thus, they are marked clinically by hemoptysis, and the sequelae to bronchial irritation and obstruction, i.e., cough, wheezing (usually unilateral), fever, chest pain and dyspnea. Fifteen per cent of a series of 100 cases quoted by Moersch and Harnington had no pulmonary symptom, presumably because they did not cause obstruction or interfere with drainage of the bronchus. Chest x-ray findings are usually those of atelectasis, though occasionally a well-delineated, round density is seen.