papillary adenoma

Papillary Adenoma: A Rare Benign Tumor

A papillary adenoma is a rare benign tumor that can occur in various parts of the body, including the kidney and lung. It is characterized by its distinctive papillary or tubular architecture, with low-grade nuclei.

• Kidney Papillary Adenoma: In the kidneys, papillary adenomas are small, unencapsulated tumors composed of cells arranged in a papillary or tubular structure, measuring 15mm or smaller in diameter [3][12].
• Lung Papillary Adenoma: In the lungs, pulmonary papillary adenoma is an extremely rare benign epithelial tumor that occurs in the periphery of the lung, characterized by widespread papillary structures [4][9].

Key Features

Papillary adenomas are typically small and have a low-grade nuclear architecture. They can be found in various parts of the body, including the kidney and lung.

• Size: Papillary adenomas are usually small, measuring 15mm or smaller in diameter.
• Architecture: The tumors are characterized by their papillary or tubular structure.
• Nuclear Grade: The nuclei of the tumor cells are low-grade.

Diagnosis

A diagnosis of papillary adenoma is typically made through histopathological examination. It's essential to exercise caution when diagnosing papillary adenomas, as they can be mistaken for more aggressive tumors [12].

References

[3] Papillary adenomas are benign renal tumors that are low-grade papillary neoplasms that are 15mm or fewer in size. [4] In summary, pulmonary papillary adenoma is an extremely rare benign epithelial tumor occurring in the periphery of the lung. [9] Pulmonary papillary adenoma is an extremely rare tumor characterized by widespread papillary structures. [12] Papillary adenoma is unencapsulated tumor composed of cells with low ISUP/WHO grade arranged in papillary or tubular architecture and 15 mm in diameter or smaller.

Papillary adenomas can have various signs and symptoms, although they are often non-specific and may not be immediately apparent. Here are some possible symptoms:

• Non-specific symptoms: These can include cough, shortness of breath, asthma, and other respiratory issues [8].
• Compressive symptoms: Large nodules can cause difficulty swallowing, food or pills getting "stuck" when trying to swallow, and pressure or discomfort in the throat or chest area [7].
• Neck-related symptoms: Papillary thyroid cancer, which is related to papillary adenoma, can cause neck pain, swelling of lymph nodes, inflammation, trouble swallowing or breathing (or both), and a lump or nodule in the front of the neck [12][13].

It's essential to note that many people with papillary adenomas may not experience any symptoms at all. If you're concerned about your health, it's always best to consult with a healthcare professional for personalized advice.

References:

[7] Very large nodules may cause compressive symptoms which include difficulty swallowing, food or pills getting "stuck" when they swallow, and pressure or discomfort in the throat or chest area. [8] by LQ Chen · 2024 — Typically, clinical symptoms of primary lung papillary adenoma are non-specific, and can manifest as cough, shortness of breath, asthma and ... [12] Thyroid cancer often has few signs or symptoms. When symptoms do appear, they vary from person to person. They may include: A lump or nodule in the front of the neck; ... The bruise is caused by a needle biopsy of the tumor. [13] Neck pain: Papillary thyroid cancer can cause pain or discomfort in the neck, especially if the tumor is large or has spread to nearby tissues.

Diagnostic Tests for Papillary Adenoma

Papillary adenoma, also known as papillary thyroid carcinoma (PTC), can be diagnosed using various imaging tests and procedures.

• Imaging tests: Imaging tests such as ultrasound, CT scans, and MRI scans may be used to help find suspicious areas that might be cancer, determine the extent of surgery, and assess the spread of cancer. [1][2]
• Fine-needle aspiration biopsy (FNAB): FNAB is a common diagnostic test for papillary thyroid cancer. During this procedure, a thin needle is inserted into the thyroid nodule to collect cells for examination under a microscope. [12][14]
• Thyroid function tests: Thyroid function tests may be done to check the levels of thyroid hormones in the blood and to assess the functioning of the thyroid gland. [3]
• TSH suppression test: The TSH suppression test is useful for monitoring papillary thyroid cancer cases, especially after surgery. This test measures the level of thyroid-stimulating hormone (TSH) in the blood. [4]
• Immunohistochemical findings: Immunohistochemical staining may be used to identify specific proteins or markers in the tumor cells, which can help confirm the diagnosis of papillary adenoma. For example, CD68 staining highlights the presence of histiocytes in the tumor, while Ki-67 is expressed in less than 2% of all tumor cells. [6]

Other diagnostic tests

• Endoscopic papillectomy (EP): EP is a minimally invasive procedure that may be used to diagnose and treat certain types of thyroid tumors.
• Molecular testing: Molecular testing, such as genetic mutation analysis, may be used to identify specific genetic mutations associated with papillary adenoma.

References

[1] Context 2 [2] Context 5 [3] Context 3 [4] Context 4 [6] Context 6

Treatment Options for Papillary Adenoma

Papillary adenomas are typically benign tumors that can be treated in various ways, depending on their size and location. While surgery is often the most common treatment option, drug treatment can also be effective in managing these tumors.

• Chemotherapy: Chemotherapy may not be a primary treatment for papillary adenomas, as they are usually benign and slow-growing. However, in some cases, chemotherapy may be used to manage symptoms or slow down tumor growth (see [2] and [3]).
• Targeted Therapy: Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. For papillary adenomas, targeted therapy may involve using medications such as sorafenib (see [7]) or BRAF and MEK inhibitors (see [13]). These treatments can be effective in shrinking tumors or slowing down their growth.
• Hormone Therapy: Hormone therapy is not typically used to treat papillary adenomas, as these tumors are usually hormone-independent.

Key Considerations

When considering drug treatment for a papillary adenoma, it's essential to discuss the following with your healthcare team:

• The size and location of the tumor
• The potential risks and benefits of different treatments
• Any underlying health conditions that may impact treatment options

By working closely with your healthcare team, you can determine the best course of treatment for your specific situation.

References

[2] - Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. There are many different chemotherapy drugs that can be used alone or in combination. [3] - Papillary thyroid cancer begins in the follicular cells in your thyroid that produce thyroglobulin (a protein). Surgery is the most common treatment for PTC. [7] - Several targeted medications are available to treat thyroid cancer. NYU Langone doctors may use a drug called sorafenib to treat advanced papillary carcinoma. [13] - Targeted drugs for papillary or follicular thyroid cancer. Targeted drugs are often the preferred treatment if the cancer cells have certain gene changes.

The differential diagnosis of papillary adenoma, also known as renal papillary adenoma or pulmonary papillary adenoma, includes several conditions that can be confused with it based on their similar histological and clinical features.

• Alveolar adenoma: This is a rare epithelial tumor that can be mistaken for papillary adenoma due to its multicystic histology and resemblance to normal lung parenchyma [10].
• Sclerosing pneumocytoma: This condition may have the same origin as papillary adenoma, making differential diagnosis challenging [10].
• Glandular papilloma: This is another condition that can be confused with papillary adenoma due to its similar histological features.
• Papillary adenocarcinoma: This is a type of cancer that can be mistaken for papillary adenoma based on its papillary architecture and cellular morphology [13].
• Bronchial papilloma: This condition can also be confused with papillary adenoma due to its similar histological features.
• Sclerosing hemangioma: This is a rare vascular tumor that can be mistaken for papillary adenoma based on its similar histological features.
• Pseudoglandular carcinoid tumor: This is a type of neuroendocrine tumor that can be confused with papillary adenoma due to its similar histological features [5].

It's worth noting that the differential diagnosis of papillary adenoma can be challenging, and a thorough examination of clinical and histopathological features is necessary to arrive at an accurate diagnosis.

References: [10] - The context mentions that alveolar adenoma has a characteristic multicystic histology and often resembles the normal lung parenchyma. [5] - The context mentions that pseudoglandular carcinoid tumor can be confused with papillary adenoma due to its similar histological features. [13] - The context mentions that papillary adenocarcinoma is a type of cancer that can be mistaken for papillary adenoma based on its papillary architecture and cellular morphology.