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The vast majority of tumours arising in the bronchopulmonary system are malignant in nature. Benign tumours of the lung are relatively rare and are often incidental findings during clinical investigations for unrelated conditions. These lesions can arise in the bronchial tree or the pulmonary parenchyma and may be of epithelial, mesenchymal, salivary gland-type or unknown differentiation. Although the spectrum of these lesions is wide, the clinical, pathological and immunohistochemical characteristics of the most relevant will be the subject of this review. In addition, the most important features allowing differentiation from malignant pulmonary neoplasms will be discussed.

Summary Mucoepidermoid carcinoma is a rare pulmonary neoplasm seen in the pediatric population. We report a low grade mucoepidermoid carcinoma in a 12-year-old boy who presented with spontaneous pneumothorax. Pediatr Pulmonol. 2014; 49:E86–E89. © 2013 Wiley Periodicals, Inc.

Background Surgical resection offers the greatest likelihood of cure for appropriately selected patients with pulmonary colorectal carcinoma metastases. We hereby report our experience over the last 19 years at the Austin Hospital, Thoracic Surgery Unit. Methods This is a retrospective study of a consecutive series of patients with pulmonary colorectal cancer metastases. From 1994 to 2012, 66 patients underwent 83 pulmonary metastasectomies for colorectal cancer at the Austin Hospital. Results Seventy per cent of patients were operated on for single pulmonary metastases. The most common procedure performed was a video-assisted thoracoscopic surgery wedge resection. Median follow-up duration was 25 months. Three-, five-, seven- and ten-year survival was 53.4, 39.6, 34.6 and 23.1%, respectively. Conclusion Pulmonary metastasectomy for metastatic colorectal carcinoma continues to offer the greatest survival advantage for appropriately selected patients.

BACKGROUND Multiple chondromatous hamartomas of the lung, which are very rare, are a feature of Carney syndrome. The relation between the two entities is not clear. METHODS A patient with multiple chondromatous hamartomas of the lung is described in this article. The literature was reviewed with special reference to the relation between multiple chondromatous hamartomas of the lung and Carney syndrome as well as the triad of gastric epithelioid leiomyosarcoma, functioning extra-adrenal paraganglioma, and pulmonary chondroma. RESULTS A total of 15 cases of multiple chondromatous hamartomas of the lung have been published worldwide. Two cases exhibited two other features of Carney syndrome, namely, gastric leiomyogenic neoplasms and extra-adrenal paragangliomas, and three other cases demonstrated only gastric leiomyomatous neoplasms. These five patients were all young females. CONCLUSIONS Some patients with multiple chondromatous hamartomas of the lung have a history of Carney syndrome. Patients with multiple chondromatous hamartomas require further examination of other sites, particularly the stomach and nervous system. Cancer 1999;85:2557–61. © 1999 American Cancer Society.

To determine the relationship between radiologically determined tumor diameter and true pathologic tumor diameter and correlate radiologically determined diameter with the size of reactive zone surrounding pulmonary neoplasms, radiographs and surgical pathology specimens were obtained from 57 patients with pulmonary neoplasms. The tumor size on plane films and CT-scans was measured, as was the size of the neoplasm on gross specimen and surgical pathology slide. The width of the reactive zone was also measured on H&E stained microscopic slides. These findings were correlated along the histopathologic type of neoplasm present. On average, the reactive zone represented approximately 11% of the overall diameter of the neoplasm. However, there was considerable variation in this percentage, with reactive zone thickness varying between 2% and 48% of total tumor diameter. Bronchioloalveolar cell carcinomas generally lacked a reactive zone, while the other types of carcinomas frequently contained reactive zone. Approximately half of all carcinomas displayed a reactive zone of 1 mm in thickness or more. The present study demonstrates that a majority of carcinomas contain a reactive zone. This reactive zone is of variable thickness, but in approximately 50% of carcinomas it is at least 1 mm in thickness. The thickness of the reactive zone east 1 mm in thickness. The thickness of the reactive zone represents approximately 11% of total tumor diameter.

In order to evaluate the usefulness of cell-block (CB) from bronchial washing in the diagnosis of pulmonary neoplasms, we examined cytological samples of 1,145 bronchoscopies; CBs could be prepared in 777 cases (67.9%) and 201 cases, positive or suspicious for malignancy, were selected for the study (173/201 smears: 86.1%; 174/201 CBs: 86.6%). CBs were positive in 12 cases while the corresponding smears were negative (10 cases) or suspicious (2 cases); 2 cases had suspicious CBs with negative smears. Thus, the use of CBs increased the positive diagnosis from 173 to 185 cases, for an increase of 6.5%. We can conclude that CB could be a routine, inexpensive method, helpful in pulmonary neoplasm's diagnosis; moreover, CB has the advantage of being an histologic specimen, often the only one, useful for other diagnostic procedures. Diagn Cytopathol 1996;15:191–192. © 1996 Wiley-Liss, Inc.

The volume doubling time (DT) of human lung neoplasms, determined from sequential, presurgery roentgenograms, was compared with biochemical and histologic observations on biopsy samples of the same tumors obtained during surgery. The DTs of the 16 neoplasms ranged from 24 days in an oat cell carcinoma to over 500 in a pulmonary carcinoid tumor, and showed a statistically significant, inverse correlation to the TK (thymidine kinase) and the UK (uridine kinase) concentration of the biopsy samples per g wet weight or mg DNA. Log DT bore a linear relationship to log TK (r = 0.75, P = 0.0008) and to log UK (r = 0.69, P = 0.0067), and an even better fit to the straight line was found when plotting the log of the standardized average of the two enzymes against log DT. The results demonstrate the feasibility of a biochemical method for determining the unknown DT of the many tumors that are not amenable (on account of shape, location, or lack of prior chest x-rays) to the direct, radiologic determination of this useful, dynamic parameter of clinical malignancy.

The light microscopic and ultrastructural features of five asymptomatic peripheral carcinoids presented as distinct pulmonary solitary nodules are described. By conventional microscopy the tumors displayed a variety of histologic patterns, the most unusual one showing tumor cells embedded in a richly vascular hyalinized stroma and forming papillary structures or cystic spaces lined by low cuboidal cells which ultrastructurally bore a strong resemblance to intermediate or transitional forms between types I and II pneumocytes. A striking feature of these tumors was their rich vasculature associated with a marked perivascular sclerosis composed of basement membrane-like material and collagen fibrils most likely produced by the increased numbers of pericytes surrounding these sclerotic vessels. The clinical implications, biologic behavior, and association of these tumors with other pulmonary neoplasms are also discussed.

Results of transthoracic needle biopsy have been evaluated on the basis of fourteen years experience comprising 5300 procedures on 2726 patients. In 90.7% of the cases a diagnosis was established. Of these, 46.4% showed cytological evidence of primary or secondary malignancy. In 2.4% false positives and in 3% false negatives were noted. The most important complication was found to be pneumothorax, which was noted in 27.2%, but these cases did not as a rule call for treatment. Hemoptysis was observed in 2-5%. There was minor local bleeding around the lesion in 11% of the patients but this only required observation. In one case out of 1264 malignancies an implantation metastasis was found. There was a single case of air embolism with spontaneous recovery, but no mortality in this series. In our experience, needle biopsy represents a minor, inexpensive and safe procedure, which--with a simple technique--permits a direct approach to all kinds of localized lung lesion with a high degree of accuracy.