Alveolar elastosis in peripheral pulmonary adenocarcinoma in relation to tumor development.

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Forty-one primary peripheral pulmonary adenocarcinoma less than 2 cm in diameter were studied histologically, radiologically and clinicopathologically. Histologically, from the patterns of elastosis in the tumor stroma, the tumors could be classified into two types. Type 1 tumors showed preservation of the alveolar network consisting of the hypertrophic alveolar wall of elastosis lined with tumor cells. Type 2 tumors, on the contrary, revealed an irregular alveolar network of the also hypertrophic wall of converged or clustered elastic fibers or formation of localized fibrotic foci in the tumor.<BR>Radiologically, type 1 showed a roentgenographic course in which the tumor size hardly enlarged and the density tended to increase gradually over a long time. The roentgenographic course of type 2 revealed that the tumor size increased and the density tended to increase abruptly over a short time.<BR>Based on postoperative pathological examinations, cases with type 2 tumors frequently showed vascular permeation of tumor cells or lymph node involvement of the tumor.<BR>These results may suggest that the converging or fragmented elastic fibers in the tumor stroma are due to disrupted alveolar structures, which indicate tumor invasion into the alveolar walls.
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