CT Features of Bronchiolo-Alveolar Carcinoma
GALINA I. KIROVA ; ALEXANDER D. SIMIDCHIEV ; VESSELIN I. VLASSOV ; GEORGI T. KALAYDJIEV ; DANAIL B. PETROV ; DIMITAR T. KOSTADINOV
Bronchioloalveolar carcinoma (BAC) is a histologically distinct form of pulmonary adenocarcinoma, accounting for 1 to 9% of all pulmonary neoplasms. Its radiological appearance includes nodular, pneumonic and diffuse patterns. The aim of the study is to report the different radiographic patterns of this neoplasm with particular emphasis on CT findings and those signs that may help in identifying the lesion as BAC. We analysed retrospectively the CT scans of 19 patients (7 women and 12 men) with histologically proven BAC to identify the signs, which could lead to improved diagnostic criteria. These signs are represented by ground-glass opacity in 79% (n=15) and alveolar consolidation 53% (n=10), with a plurilobular, segmentary or lobar distribution. The lesions were bilateral in 47.4% (n=9) cases and abnormal mediastinal lymph nodes were found in 42% (n=8) cases. Air bronchiologram was seen in 40% (n=6) of the diffuse forms and in 60% (n=3) of nodular cases. Our experience shows that CT is a useful tool in the diagnostic workup of BAC, which has a long and slow evolution and is underestimated at plain chest radiograph in its early stages. Moreover CT can help to distinguish this condition from other lung diseases characterized by diffuse air-space consolidation, whose clinical history is useless in making an accurate diagnosis.