Exams and Tests continued...
None of the above techniques accurately differentiate bronchial adenoma from other neoplasms (growths). Other tests and procedures include the following:
- Octreotide nuclear scan is a test used to detect carcinoid tumors and to determine sites to which they have spread.
- Bronchoscopy: This procedure is used to see the inside of the trachea (windpipe) and large airways in the lung for abnormal growths. After giving the person a sedative, the doctor numbs the throat and windpipe with local anesthesia. A bronchoscope, a thin, flexible, lighted tube with a tiny camera at the end, is inserted through the mouth or nose and then down the windpipe. From there, the bronchoscope can be used to look at the airways (bronchi) of the lungs. During bronchoscopy, the doctor may perform a biopsy (a sample of cells removed for examination under a microscope) on the tumor.
- Transbronchoscopic fine-needle aspiration: If the lesion is not easily accessible on the airway wall or is less than 2 cm in diameter, a fine-needle aspiration biopsy may be performed as a part of the bronchoscopic examination.
- CT-guided fine-needle aspiration: If a peripheral nodule is present, a needle may be inserted through the chest wall, between the ribs, and placed in the nodule. This biopsy specimen can be examined under the microscope to determine if the nodule is benign (noncancerous) or malignant.
If these tests are nondiagnostic and if malignancy is likely, a thoracoscopic procedure or an open thoracotomy (incision through the chest wall) may be performed.
Adenoma Treatment - Surgery
If a person has been diagnosed with bronchial adenoma, the tumor is removed through bronchoscopic surgery; open lung surgery; or video-assisted thoracic surgery (VATS), a form of minimally invasive surgery.
Bronchoscopic surgery may be performed if the tumor is small and limited to the airways. In this surgery, the tumor may not be completely removed. Also, the chances of profuse bleeding are higher. Therefore, bronchoscopic surgery for tumor removal is only recommended in people who cannot undergo open lung surgery or VATS because of other health conditions.
The tumor can also be ablated through the bronchoscope using a laser. However, this method is not recommended as a primary mode of tumor removal and is usually used only for recurrent tumors.
Following surgical resection (removal), the overall 5-year survival rate for people with bronchial adenoma is about 95%. Long-term follow-up studies in most series report little evidence of local recurrence or distant metastases following surgical removal of bronchial adenoma. However, a few reports exist of local recurrence or distant metastases following adequate resection.
Overall, the long-term prognosis for people with bronchial adenoma is excellent; therefore, limited resection should be used whenever possible.