Case 6. (08 Dec. 1997)
Diagnosis: Bronchioloalveolar carcinoma
Brief discussion:
Bronchioloalveolar cell carcinoma has a wide spectrum
of pathologic and radiologic appearances. It typically has one of
three radiologic patterns. Those are a solitary nodule (43%), consolidation
(30%), and multicentric or diffuse disease (27%). Other associated features
are pleural effusion (32%) and hilar or mediastinal lymphadenopathy (18%).
Solitary nodules are located in the periphery of the lungs and show spiculated
borders (star pattern, due to infiltrative tumor growth, localized lymphangitic
spread, or desmoplastic reaction), pleural tags, bubblelike lucencies or
pseudocavitation. Segmental or lobar consolidation can be caused by the
combination of tumor growth along the alveolar wall and secretion of mucin.
Production of mucin can cause swelling of the lobe, leading to bulging
of interlobar fissure, and heterogenous attenuation in small masses or
uniform low attenuation with CT angiogram sign in more confluent consolidation.
In the third form, bronchioloalveolar cell carcinoma may have a widespread
multinodular pattern.
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