🌬️ Bronchial adenoma is a historic term once used for rare airway tumours. Although the word “adenoma” suggests benign behaviour, these tumours can be benign or malignant. Today, it refers mainly to specific tumour types: carcinoid tumours, adenoid cystic carcinoma, and mucoepidermoid carcinoma.

📖 About

Rare tumours, often slow-growing but locally invasive ⚠️
Can occur at any age, but more common in middle adulthood

🗂️ Types

Carcinoid Tumours: Most common.
- Typical carcinoid → slow, less aggressive ✅
- Atypical carcinoid → more aggressive, higher recurrence risk ⚠️
Adenoid Cystic Carcinoma: Rare, indolent but infiltrative.
Mucoepidermoid Carcinoma: Variable behaviour (low- vs high-grade forms).

🧬 Risk Factors

📆 Age: Middle-aged adults most affected.
🚬 Smoking: Not as strongly linked as lung cancer, but a risk especially for mucoepidermoid carcinoma.
🧪 Genetics: Familial predisposition in some cases.

🔎 Symptoms

💨 Cough: Persistent, may include haemoptysis.
🎵 Wheezing: Often localised, may mimic asthma.
😮‍💨 Dyspnoea: From airway obstruction.
♻️ Recurrent infections: Same lobe pneumonia → obstruction clue.
⚡ Chest pain: If invasive.

⚠️ Red Flags: - Haemoptysis - Recurrent pneumonia in same lobe - Wheeze not responding to inhalers

🧾 Differentials

🦠 Tuberculosis (TB)
🫁 Primary lung carcinoma
🌿 Sarcoidosis

🧪 Investigations

🩻 Chest X-ray: May show a hilar/airway mass or collapse.
🖼️ CT Scan: Defines location, extent, invasion.
📡 Bronchoscopy: Direct visualisation + biopsy.
🔬 Histology: Confirms type (carcinoid, ACC, mucoepidermoid).

🛠️ Management

🔪 Surgery: Mainstay if resectable (bronchoscopic excision → lobectomy if extensive).
☢️ Radiotherapy: For unresectable/infiltrative tumours.
💊 Chemotherapy: For aggressive subtypes (e.g. atypical carcinoid, high-grade mucoepidermoid).
🎯 Targeted therapy: Selected cases with molecular drivers.

💡 Clinical Pearl: Think bronchial tumour when an adult presents with “fixed localised wheeze or recurrent pneumonia in the same lobe despite antibiotics.” Asthma and infection rarely cause symptoms so focal.

📚 Case Example

👨 A 45-year-old non-smoker presents with a 6-month history of recurrent pneumonia affecting the right middle lobe. He has persistent cough, occasional haemoptysis, and a localised wheeze not improving with inhalers. 🩻 Chest X-ray: Right hilar opacity. 📡 Bronchoscopy: Endobronchial mass. 🔬 Biopsy: Typical carcinoid tumour. ✅ Management: Surgical resection.

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Bronchial adenoma