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Chapter 30 - Salivary gland neoplasms of the lung
- Edited by Philip Hasleton, University of Manchester, Douglas B. Flieder, Fox Chase Cancer Center, Philadelphia
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- Book:
- Spencer's Pathology of the Lung
- Published online:
- 05 June 2014
- Print publication:
- 01 January 2000, pp 1127-1150
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- Chapter
- Export citation
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Summary
Introduction
Primary salivary gland tumors of the lung are extremely rare and comprise only 0.1% to 0.2% of all lung cancers. The seromucinous glands of trachea and bronchi are similar to the minor salivary glands, and therefore they share histologically identical tumors. Historically, the term bronchial adenoma was used for primary pulmonary salivary gland tumors and bronchial carcinoids. However, it is clear that salivary gland tumors of the lung represent distinct, usually slow growing, low-grade neoplasms. Patients with salivary gland lung tumors are, on average, younger than other bronchogenic carcinoma patients. Overall, these tumors have a weaker association with smoking, as up to 40% of patients are non-smokers. Since primary salivary gland lung tumors may present a diagnostic challenge, it is of vital importance that sufficient material be submitted for pathological analysis. The bronchoscopic evaluation should be carefully conducted while keeping in mind the goal of a bronchoplastic resection, whenever appropriate. Given the importance of lymph node involvement as a prognostic indicator, mediastinal lymph node sampling or dissection should be diligently performed in all patients. Since complete surgical resection appears to be the best predictor of long-term survival, every effort should be made to achieve this goal.
Only small case series are available to demonstrate the presentation, diagnosis and management of these tumors. It should be kept in mind that generalizations regarding the treatment and prognosis of these tumors are limited by the very small sample size of published case series. Similarly, a limited number of genetic studies have been published. It appears that besides morphology, salivary gland tumors of the lung have similar genetic abnormalities to their salivary gland counterparts.