Terminal bronchiolar or “alveolar cell” cancer of the lung. Two hundred sixty-five cases

Abstract

A study of 265 patients with terminal bronchiolar carcinoma of the lung was made. In the majority of cases the disease ran a rapid clinical course. In 11.7% the disease was asymptomatic. The diagnosis first was established by the cytologist in 83 instances—sputum studies (45), bronchial washings (23), pleural fluid (15). Distinguishing features of this disease are seen both in its gross and microscopic appearance. Grossly, it has been divided into 2 forms—nodular and diffuse. Cytologically, the 2 forms are identical. The most effective treatment is excisional surgery. A study of 82 cases coming to autopsy reveals the aggressiveness of this disease and its tendency to spread early and widely by way of both the blood and lymph vessels. A surprising number of metastases occurred to the brain and the adrenals. Of 82 patients treated with excisional surgery, 16 survived for more than 5 years, and 52 still are living after 4 years.

Early-stage pulmonary adenocarcinoma (T1N0M0): a clinical, radiological, surgical, and pathological correlation of 104 cases. The MD Anderson Cancer Center Experience

“…Historically, the term has been under much debate and different views have been presented to attest to its clinical behavior without, however, producing a unifying agreement. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] In 1960, Liebow 20 introduced the term bronchioloalveolar carcinoma to describe a well-differentiated adenocarcinoma that may have long dormancy or slow growth, particularly in those patients presenting with isolated nodules. More recently and exclusively looking at the solitary nodule pattern, there have been proposals for a change in the nomenclature of pulmonary adenocarcinomas with a pure lepidic or bronchioloalveolar growth pattern.…”

Well-Differentiated Adenocarcinoma—Bronchioloalveolar Carcinoma—In Situ Adenocarcinoma

“…Needless to say, the many variations have brought considerable controversy to this topic. [6][7][8][9][10][11][12][13][14][15] In 2004, the authors of the WHO publication on Tumours of the Lung, Pleura, Thymus and Heart, 16 without alluding to the term in situ adenocarcinoma, defined bronchioloalveolar carcinoma as a small adenocarcinoma with lepidic growth but without stromal, pleural, or lymphatic invasion, which essentially left the reader to interpret such a tumor as an in situ lesion. Important to note is that the original term bronchioloalveolar carcinoma was maintained; only the definition was modified.…”

“…[6][7][8][9][10][11][12][13][14][15] It is important to recognize that much of the discussion in these early publications concentrated more on the origin of the neoplasm, namely whether it originated from the terminal airways or from the alveolar cells. In this context, it is important to highlight that in the majority of cases reported, the tumor was not confined to the lung proper, but invasion of pleura and lymph nodes, and even extrathoracic involvement was documented.…”

Bronchioloalveolar carcinoma: computed tomography findings

“…Histopathologically, it is classified as a subtype of adenocarcinoma and is characterized by its tendency to spread locally, using the lung structure as stroma, without destroying the underlying architecture [4][5][6]9]. Some of the distinguishing pathologic and epidemiological features of BAC include: peripheral location [10,11]; association with desmoplastic reaction (scarring) [12]; mucin production [13,14]; high occurrence (30%) in nonsmokers [15,16]; comparatively high female-to-male ratio (1:1 versus 1:3 for all other cell types of lung cancer) [17]; and tendency to appear in multiple foci [18,19]. Furthermore, recent evidence suggests that adenocarcinoma of the lung has increased in the last decade, and that this overall increase in adenocarcinoma is largely due to an increase in BAC [20].…”