Abstract
Introduction: The bronchiolo-alveolar carcinoma is a rare form of adenocarcinoma, which is more often diagnosed at non-smokers.
Description: We present a series of 8 patients (7 women), evaluated for bronchiolo-alveolar carcinoma in our clinic between 1th January 2009 and 31th December 2013. Five cases were non-smokers. The median age was 50 years old (range 33-62).
The clinical examination showed progressive dyspnea(8), cough(8), increased sputum production (5), fever(2), thoracic pain (3).
In 7 patients the chest radiography revealed multiple bilateral pulmonary opacities, with air bronchogram and tendency to necrosis at 1. One patient had 2 pulmonary nodules.
The diagnosis required bronchoscopy and tumor cells were identified at broncho-alveolar lavage (5). At 2 patients lung biopsy was needed for the diagnosis and 1 diagnosis was made on necropsy.
The most important challenge was the differential diagnosis with the Staphylococcus pneumonia, tuberculosis, vasculitis due to clinical pictures and the bilateral pulmonary abscesses. Four patients received antibiotics and 2 tuberculosis treatment, with no improvement. The delay of diagnosis was between 2 to 15 months.
Two patients had lobectomy. All patients received chemotherapy. Survival was poor in 2 cases with 3 and 6 weeks survival from diagnosis.
Conclusion: The bronchiolo-alveolar carcinoma is a form of adenocarcinoma, with a high prevalence in nonsmoker women. The diagnosis is often delayed due to the clinical pattern, which may resemble to infectious disease. Due to the extension of the disease at diagnosis, the prognosis in this subtype of lung cancer is poor in most cases.
- © 2014 ERS