Bronchioloalveolar Carcinoma

Abstract

In Brief Introduction: Bronchioloalveolar carcinoma (BAC) has nonspecific clinical and roentgenographic characteristics. The purpose of this study is to review the clinical manifestations, radiographic features, diagnostic strategies, treatments, and survival of BAC at a large urban teaching hospital. Materials and Methods: The authors conducted a retrospective review of the records of 40 patients diagnosed with BAC at a large community teaching hospital during an 8-year period. Results: The mean age was 67.5 years (range, 42–85 years), 62.5% were females, and 75% were smokers. Fifty-five percent of patients were symptomatic at the time of diagnosis. TNM staging (either clinical for those treated medically or surgical for those undergoing resection) revealed: 30% stage I, 5% stage II, 20% stage III, and 42.5% stage IV. A total of 52.5% were treated surgically. The remainder was treated with palliative chemotherapy, radiation, or both. The overall 1- and 2-year survival rates were 70% and 47%, respectively. The 1- and 2-year survival rates for stage I and II were 100% and 84%, respectively. For stages III and IV, they were 54% and 26%. In addition, we observed a trend toward better outcomes in patients treated surgically with curative intent. Conclusions: In our series, the majority of patients with BAC were females with a significant smoking history. Most patients presented with a solitary mass in a unifocal pattern. Air bronchogram as seen on computed tomography scan imaging was a frequent radiographic finding (32.5% of patients). Bronchorrhea was seen only in one patient. Open thoracotomy, video-assisted thoracic surgery, and computed tomography-guided needle biopsy were the more frequently used diagnostic procedures. Fiberoptic bronchoscopy was usually nondiagnostic. Overall, the staging, treatment, and prognosis of BAC were similar to those with other types of nonsmall cell lung cancer. However, we observed a trend toward better outcome when patients underwent surgery with curative intent. Bronchioloalveolar carcinoma (BAC) has nonspecific clinical and roentgenographic characteristics. In this article, the clinical manifestations, radiographic features, diagnostic strategies, treatments, and survival of 40 patients with BAC at a large urban teaching hospital are presented along with a review of existing literature. The majority of patients were females with a significant smoking history and air bronchograms were a frequent radiographic finding. Overall, the staging, treatment, and prognosis were similar to other types of nonsmall cell lung cancer (NSCLC); however, a trend toward better outcome was observed when patients underwent surgery with curative intent.