Bronchial Glands: Age, Regional and Individual Structural Features

The aim was to study the quantitative indicators and structure of the distribution of the glands in human main bronchi in the age aspect.Material and methods. The object of the study was the glands in the walls of the main bronchi, obtained as a single complex together with the lower part of the trachea, including the area of bifurcation. Samples were taken from 110 corpses of people in the age range from the neonatal period to 87 years (10 observations in each age group), who died from causes not related to the pathology of the respiratory system and did not have pathological changes in the respiratory system at autopsy. For micro-macroscopy using an MBS-9 binocular microscope, the glands in the walls of the main bronchi were selectively stained with methylene blue according to R.D. Sinelnikov, followed by fixation in a saturated solution of ammonium picric acid. The following characteristics were analyzed: the shape of the glands, their total number on the total preparation, the density of their location (the number of the mouths of the excretory ducts per 1 cm2), the width of their initial section. Due to the normal distribution of the data, the methods of parametric statistics based on the Statistica 6.0 program were used for statistical data processing. Statistical data processing included the calculation of the arithmetic mean indicators, their errors, the analysis of the amplitude of the variation series of each indicator was carried out.Results. The performed macro-microscopic examination revealed an asymmetry in the distribution of glands – the number and density of distribution of glands was 1.50–2.10 times higher (p <0.05) for the left bronchus than for the right and 1.56–2.91 (p <0.05) times more in the cartilaginous than in the membranous part. At the same time, the width of the orifice of the gland showed opposite patterns. In terms of age, there was an increase in the number of glands and their size with a maximum by the age of 21–35 and a subsequent decrease by senil age. The distribution density decreased throughout the entire period of life.Conclusion. The revealed age, regional and individual features of the structure of the glandular apparatus of the main human bronchi may be of interest both in scientific research and in clinical practice, forming a basic description of the structural norm.

Robotic Resection of Pulmonary Epithelial Myoepithelial Carcinoma: A Case Report

Background Pulmonary epithelial–myoepithelial carcinoma (P-EMC) is an extremely rare, well-differentiated, and malignant neoplasm originating from submucosal bronchial glands in the lung. EMCs arise mainly in the salivary glands. Case Description This case represents an asymptomatic 78-year-old male with a remote 75-pack-year history of smoking who presents with a solitary endobronchial lesion, which is suggestive of a primary lung EMC, detected on annual screening chest computed tomography (CT) scan. Conclusion A recent review of literature reveals less than 50 documented cases of the pulmonary subtype of this tumor worldwide. We are reporting a unique case of robot-assisted pulmonary lobectomy for a P-EMC.

Evaluation of lymphocytic infiltration in the bronchial glands of Sjögren’s syndrome in transbronchial lung cryobiopsy

Background Sjögren’s syndrome (SS) is a systemic autoimmune disease characterized by deteriorated exocrine gland function with associated lymphocytic infiltration. However, there are few pathological studies on bronchial glands in SS. In this study, we aimed to clarify pathological features of bronchial glands in SS. Methods We retrospectively evaluated infiltration of lymphocytes in the bronchial glands incidentally collected by transbronchial lung cryobiopsy (TBLC), which were performed for the diagnosis of diffuse lung diseases. The degrees of lymphocyte infiltration in the bronchial glands were classified into four grades (grade 0–3). We compared the degrees of infiltration of SS with those of other diffuse lung diseases. Results TBLC for diagnosis of diffuse lung diseases were performed on 432 cases during the study period. The samples of 50 cases included bronchial glands. Of those, 20 cases were excluded due to insufficient size or influence of therapy. The remaining 30 cases included 17 of idiopathic interstitial pneumonias, 5 of chronic hypersensitivity pneumonia, 6 of connective tissue disease (SS; n = 4, systemic sclerosis; n = 1, dermatomyositis; n = 1) and 2 of other diseases. In SS, infiltration of lymphocytes was observed in all cases; grade 1 in one, grade 2 in one, and grade 3 in two cases. In contrast, 11 of 26 in other diseases showed no lymphocytes infiltration, with the remaining 15 of grade 1 infiltration. Grade 2 or more infiltration were found only in SS but not in other diseases. Conclusion Our results suggested that high-grade lymphocytic infiltration of bronchial glands is a distinct characteristics in SS.

Evaluation of lymphocytic infiltration in the bronchial glands of Sjögren's syndrome in transbronchial lung cryobiopsy

Background: Sjögren's syndrome (SS) is a systemic autoimmune disease characterized by deteriorated exocrine gland function with associated lymphocytic infiltration. However, there are few pathological studies on bronchial glands in SS. In this study, we aimed to clarify pathological features of bronchial glands in SS.Methods: We retrospectively evaluated infiltration of lymphocytes in the bronchial glands incidentally collected by transbronchial lung cryobiopsy (TBLC), which were performed for the diagnosis of diffuse lung diseases. The degrees of lymphocyte infiltration in the bronchial glands were classified into four grades (grade 0-3). We compared the degrees of infiltration of SS with those of other diffuse lung diseases.Results: TBLC for diagnosis of diffuse lung diseases were performed on 432 cases during the study period. The samples of 50 cases included bronchial glands. Of those, 20 cases were excluded due to insufficient size or influence of therapy. The remaining 30 cases included 17 of idiopathic interstitial pneumonias, 5 of chronic hypersensitivity pneumonia, 6 of connective tissue disease (SS; n=4, systemic sclerosis; n=1, dermatomyositis; n=1) and 2 of other diseases. In SS, infiltration of lymphocytes was observed in all cases; grade 1 in one, grade 2 in one, and grade 3 in two cases. In contrast, 11 of 26 in other diseases showed no lymphocytes infiltration, with the remaining 15 of grade 1 infiltration. Grade 2 or more infiltration were found only in SS but not in other diseases.Conclusion: Our results suggested that high-grade lymphocytic infiltration of bronchial glands is a distinct characteristics in SS.

Evaluation of Lymphocytic Infiltration in the Bronchial Glands of Sjögren's Syndrome in Transbronchial Lung Cryobiopsy

Background: Sjögren's syndrome (SS) is a systemic autoimmune disease characterized by deteriorated exocrine gland function with associated lymphocytic infiltration. However, there are few pathological studies on bronchial glands in SS. In this study, we aimed to clarify pathological features of bronchial glands in SS. Methods: We retrospectively evaluated infiltration of lymphocytes in the bronchial glands incidentally collected by transbronchial lung cryobiopsy (TBLC), which were performed for the diagnosis of diffuse lung diseases. The degrees of lymphocyte infiltration in the bronchial glands were classified into four grades (grade 0-3). We compared the degrees of infiltration of SS with those of other diffuse lung diseases. Results: TBLC for diagnosis of diffuse lung diseases were performed on 432 cases during the study period. The samples of 50 cases included bronchial glands. Of those, 20 cases were excluded due to insufficient size or influence of therapy. The remaining 30 cases included 17 of idiopathic interstitial pneumonias, 5 of chronic hypersensitivity pneumonia, 6 of connective tissue disease (SS; n=4, systemic sclerosis; n=1, dermatomyositis; n=1) and 2 of other diseases. In SS, infiltration of lymphocytes was observed in all cases; grade 1 in one, grade 2 in one, and grade 3 in two cases. In contrast, 11 of 26 in other diseases showed no lymphocytes infiltration, with the remaining 15 of grade 1 infiltration. Grade 2 or more infiltration were found only in SS but not in other diseases. Conclusion: Our results suggested that high-grade lymphocytic infiltration of bronchial glands is a distinct characteristics in SS.

The First Reported Pediatric Case of Primary Myoepithelial Carcinoma Involving the Whole Lung: Surgical Radical Treatment and Prosthesis Implant

Primary myoepithelial carcinoma of the lung (PMC-L) arising from the bronchial glands in lower respiratory tract is exceedingly rare. Thus far, few cases in adults and only one in a pediatric patient have been recorded. To our knowledge, this is the first report of PMC-L successfully removed in a child, focusing on the importance of multidisciplinary primary surgery for the treatment of this tumor. A 7-year-old girl was admitted for persistent cough and fever; she was unresponsive to oral antibiotics. Chest radiography showed loss of volume of left lung sustained by almost total atelectasis. After routine clinical investigations, she was referred for computed tomography scan and magnetic resonance imaging that documented the presence of a mass occupying the entire left upper lobe, infiltrating the pulmonary hilum (main bronchus, pulmonary artery, superior pulmonary vein, and pericardium). After multidisciplinary evaluation, the histopathologic diagnosis of PMC-L was established using ultrasonography-guided transthoracic core needle biopsy and bronchoscopic biopsies. She was then subjected to left pneumonectomy under extracorporeal circulation and positioning of a thoracic expander filled with 200 mL of saline solution. The postoperative course was uneventful. With TREP (very Rare Tumor in Pediatric Age) consent radiotherapy was performed (61.2 Gy). At the 10-month follow-up, the patient was alive, breathing normally without any oxygen support, without recurrence of PMC-L or metastasis, and without any chest deformity. To our knowledge, this is the first case where a pediatric patient was successfully operated for PMC-L involving the whole lung. Extracorporeal circulation enabled us to perform radical primary surgery. Prosthesis implant not only maintained normal chest expansion but also allowed focused radiotherapy, thus enabling us to prevent damage to vital organs.

Extrahepatic Nonreticuloendothelial Siderosis Is Not Specific to Gestational Alloimmune Liver Disease

Autopsy reports of 78 stillbirths and early infant deaths (up to age 8 weeks) were reviewed to investigate the prevalence of extrahepatic nonreticuloendothelial siderosis (EHNRS) in the context of neonatal liver failure. Of these, 10 liveborns (12.8%), M:F 3:2, with mean gestational age 37.6 weeks (range: 35–39) and mean age at the time of demise 19.1 days (range: 7–42), showed significant liver injury: infection (n = 7, viral > fungal), congenital malformations (n = 2), and ischemia (n = 1). None had maternal history of gestational alloimmune liver disease (GALD) or previous fetal/neonatal death due to liver failure. Seven of 10 cases (70%) showed EHNRS: pancreas (n = 6), kidneys (n = 4), thyroid and adrenal glands (n = 3), and bronchial glands and heart (n = 2). Iron deposition was most frequent in the pancreas (60%), most diffuse in the kidneys, and seen in at least 2 organs, with pancreas and kidney being the most frequent combination. Hepatic C5b-9 expression was variable (1+ to 4+) except 1 case (100% necrosis). The duration of illness and the mean age at the time of demise tended to be higher in those with EHNRS. In summary, hepatic and EHNRS, with or without C5b-9 expression, are not specific for GALD. Other causes of liver failure should be investigated as clinically and pathologically appropriate.

Diagnosis of Q Fever and Brucellosis in Aborted Ovine Fetuses by Microbiological, Pathological and Immunohistochemical Methods

Brucellosis and Q fever, two zoonoses, are important causes of abortion in ruminants, as well as economically significant diseases caused by a gram-negative bacterium. Determination of these diseases is therefore of great importance. In this study, the organs of 35 naturally infected and aborted ovine fetuses were examined for the presence of changes resulting from infections by Brucella melitensis and Coxiella burnetii, according to macroscopic, bacteriological, histopathological and immunohistochemical methods. B. melitensis was observed in 21 cases, and C. burnetii was observed in 8 cases of the aborted ovine fetuses, and these were determined with immunohistochemical methods. Brucellosis was observed in 18 of the aborted ovine fetuses, and this was determined by microbiological methods. Negative (-) results were found for all of the other fetuses. The Brucella antigen was determined to be localized as intracytoplasmic in mainly alveolar macrophages, bronchi, bronchioles, glandular epithelial cells around bronchial glands, neutrophils, hepatocytes and Kupffer cells. The Coxiella antigen was found to be localized in the alveolar macrophages in the lungs, bronchi, bronchioles and alveolus, and in the cytoplasms of bronchial gland epithelial cells, and in the cytoplasms of hepatocytes and Kupffer cells in the liver. Immunohistochemical and microbiological diagnoses of brucellosis and coxiellosis were compared; it was concluded that immunohistochemical methods were more safely applied than microbiological methods.