bronchioloalveolar carcinoma (alveolar cell carcinoma)

Etiology

• arise from alveolar type II pneumocytes &/or Clara cells
• unrelated to tobacco smoke

Pathology

• two forms
  • localized solitary nodular lesion
    • best prognosis of all forms of lung cancer
    • one year survival is > 80%
    • slow growth with chronic course of disease
  • diffuse alveolar process: mean survival < 6 months

Genetics

• upregulation of C16orf34

Clinical manifestations

• bronchorrhea
  • > 100 mL thin serous mucous secretion/24 hours (20%)
  • generally occurs with diffuse form of disease
• hemoptysis may occur
• may mimic pneumonia

Radiology

• chest X-ray
  • solitary nodule may be seen
  • pneumonic lesions may be present
• computed tomography may show localized infiltrate with vacuoles

Management

• treatment for solitary lesion is resection
• response to radiation & chemotherapy is poor
• bronchorrhea seems to respond to radiation in some patients

More general terms

• adenocarcinoma of the lung