Bronchiolar (“Alveolar Cell”) Carcinoma of the Lung

Storey, Clifford F.; Knudtson, Kenneth P.; Lawrence, Benjamin

doi:10.1016/s0096-5588(20)30803-5

Cited by 115 publications

(16 citation statements)

References 32 publications

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“…These include hemoptysis (23%, but minimal), weight loss (25%), weakness (20%), and anorexia (8%). 117 Dyspnea with severe hypoxia may not represent extensive, terminal, end-stage disease because it may result from a right-to-left shunt, with disease localized to one lobe or one lung. Fever is present in approximately 9%, usually from secondary pneumonia.…”

Section: Clinical Findings Presentation and Natural Historymentioning

confidence: 99%

“…Fever is present in approximately 9%, usually from secondary pneumonia. 117 Two-thirds of patients with unresectable disease produce sputum. 25 Bronchorrhea (Ͼ100 cc/day) is typical but infrequent (5%), 19,26,27 except in P-ADC (31%).…”

Section: Clinical Findings Presentation and Natural Historymentioning

confidence: 99%

“…118,119 Duration of symptoms can be quite long, from at least 1 year in approximately 40% of cases, to more than 2 years in 23%, to as long as 4 years in approximately 10%, in keeping with the notion of BAC being slowly progressive. 117 Many have a good performance status until late. 26,32,117 Even with advanced disease at presentation, nonpulmonary metastases are uncommon, although the range is wide (6 -32%).…”

Section: Clinical Findings Presentation and Natural Historymentioning

confidence: 99%

“…117 Many have a good performance status until late. 26,32,117 Even with advanced disease at presentation, nonpulmonary metastases are uncommon, although the range is wide (6 -32%). 9,23,25,26 Metastatic sites at presentation include bone (4 -28%), adrenal (16%) and, less frequently, brain (0 -8%) or liver (0 -4%).…”

Section: Clinical Findings Presentation and Natural Historymentioning

confidence: 99%

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The Bronchioloalveolar Carcinoma and Peripheral Adenocarcinoma Spectrum of Diseases

Garfield¹,

Cadranel

Wislez

et al. 2006

Journal of Thoracic Oncology

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Bronchioloalveolar carcinoma (BAC) develops from terminal bronchiolar and acinar epithelia, growing along alveolar septa but without evidence of vascular or pleural involvement. A final diagnosis of BAC can only be achieved from a surgical specimen. Problematically, BAC may exhibit multifocal involvement by means of diffuse aerogenous metastatic spread, making this definition inapplicable for patients with stage IIIB to IV disease from whom only small size biopsy or cytological specimens are obtained. The recent interest and potential importance of BAC and the related peripheral adenocarcinoma (ADC), mixed subtype, is attributable to mounting evidence that some, perhaps many, of what are called peripheral ADCs have arisen from and often contain BAC. BAC, in turn, appears to arise from smaller peripheral nodules, called atypical adenomatous hyperplasia. These developments could account for part of the increase in ADCs noted in some countries, in particular, in East Asia. Interest also stems from the observation that advanced ADC, often with BAC features, are responding in surprising fashion to tyrosine kinase inhibitors. Furthermore, some of the more rapid, dramatic, and durable responses occur when specific mutations in the epidermal growth factor receptor are present. Clinical characteristics often differ from other types of non-small cell lung cancers. These include frequent female occurrence, especially in East Asians; no or less smoking history; an often indolent course; distinctive chest computed tomographic findings; frequent presentation as an asymptomatic, sometimes small, peripheral nodule(s)/mass; multifocal/synchronous primary tumors; and less frequently as pneumonic-type consolidation or diffuse, inoperable lesions, the latter two often with bronchorrhea, and with chest-only disease. Relapses also are predominantly pulmonary, perhaps related to aerogenous spread, and responsible for mortality. Lobectomy is the treatment of choice for cure, even with pneumonic consolidation, but lesser procedures such as wedge resection or segmentectomy may be considered for what might be multifocal, synchronous primary tumors and for pulmonary relapses. Because of frequent lung-only recurrences, lung transplantation, although performed rarely, may hold promise.

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Section: Clinical Findings Presentation and Natural Historymentioning

confidence: 99%

Section: Clinical Findings Presentation and Natural Historymentioning

confidence: 99%

Section: Clinical Findings Presentation and Natural Historymentioning

confidence: 99%

Section: Clinical Findings Presentation and Natural Historymentioning

confidence: 99%

See 2 more Smart Citations

The Bronchioloalveolar Carcinoma and Peripheral Adenocarcinoma Spectrum of Diseases

Garfield¹,

Cadranel

Wislez

et al. 2006

Journal of Thoracic Oncology

View full text Add to dashboard Cite

show abstract

“…Accumulative evidence demonstrated it is overly simplistic to think of the process of metastasis as one governed by physical routes (i.e., lymphogenous, hematogenous). "Aerogenous" dissemination via the airways was suggested >60 years ago, implying dissemination via airways (20). Recently, the term "spread through air spaces" (STAS) has been introduced (21), but this describes an observation under the microscope immediately adjacent to the tumor, which is not indicated in our these two cases.…”

Section: Perspectivesmentioning

confidence: 99%