RT Journal Article
SR Electronic
T1 Bronchiolo-alveolar carcinoma- sometimes a difficult diagnosis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2767
VO 44
IS Suppl 58
A1 Mariana Preda
A1 Ionela Belaconi
A1 Claudia Toma
A1 Tudor Constantinescu
A1 Alina Croitoru
A1 Stefan Dumitrache-Rujinski
A1 Miron Bogdan
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2767.abstract
AB 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.