Aspectos tomográficos do carcinoma bronquíolo-alveolar e dos adenocarcinomas mistos com componente bronquíolo-alveolar

Abstract

Bronchioloalveolar carcinoma has various presentations and a wide spectrum of imaging patterns, as does adenocarcinoma with a bronchioloalveolar component. The objective of this essay was to describe and illustrate the CT findings that are most characteristic of these tumors. Three presentations are described: solitary pulmonary nodule, consolidation, and diffuse pattern. The last two should be included in the differential diagnosis, together with infectious diseases. Knowledge of the various presentations and the use of proper diagnostic procedures are crucial to early diagnosis and to improving survival.Keywords: Lung neoplasms; Adenocarcinoma, bronchiolo-alveolar; Tomography, X-ray computed. ResumoO carcinoma bronquíolo-alveolar e os adenocarcinomas mistos com componente bronquíolo-alveolar têm apresentações variadas e múltiplos padrões por imagem. O objetivo deste ensaio foi descrever e ilustrar os achados mais característicos desses tumores em TC. São descritas três apresentações: nódulo pulmonar solitário, consolidação e apresentação difusa, sendo que as duas últimas são importantes no diagnóstico diferencial com acometimento infeccioso. O conhecimento das diversas apresentações e a utilização de propedêutica diagnóstica adequada são definitivos para o diagnóstico precoce e o aumento na sobrevida.Descritores: Neoplasias pulmonares; Adenocarcinoma bronquíolo-alveolar; Tomografia computadorizada por raios X. * Study carried out at Multimagem Diagnósticos, Goiânia, at Fleury Medicine and Health, São Paulo, and at the Heart Hospital, São Paulo, Brazil. Correspondence to: Pedro Paulo Teixeira e Silva Torres Rua S-4, 452, apto. 102, Bela Vista, CEP 74823-450, Goiânia, GO, Brasil. Tel. 55 62 3212-1015. E-mail: pedroptstorres@yahoo.com Pictorial EssayAspects of bronchioloalveolar carcinoma and of adenocarcinoma with a bronchioloalveolar component: CT findings J Bras Pneumol. 2012;38(2):218-225 219 diagnostic criteria. (11) Although there is a need for universally accepted criteria for subtypes of adenocarcinoma, the authors of the proposal are aware that there will be a period of adaptation to the new terms and recommend that they be initially used concomitantly with the current nomenclature. (11) The objective of the present essay was to describe the CT findings that are most characteristic of BAC and adenocarcinoma with a bronchioloalveolar component by means of a series of illustrative cases. Imaging patterns of BAC and adenocarcinoma with a bronchioloalveolar component Pulmonary nodule and focal groundglass opacitiesA solitary pulmonary nodule, usually in the periphery of the upper lobes, is described as the most common CT finding in BAC and adenocarcinoma with a bronchioloalveolar component. (12) Most of these nodules are semisolid, with solid and ground-glass components, as well as exhibiting irregular borders and pleural indentation. (7) Although cavitation is rare in the initial presentation, some nodules can have focal lucent areas, known as pseudocavitation ( Figure 1). (7,13) There might be ca...

Looking for Lepidic Component inside Invasive Adenocarcinomas Appearing as CT Solid Solitary Pulmonary Nodules (SPNs): CT Morpho-Densitometric Features and 18-FDG PET Findings

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