A Case of Bronchiolo-alveolar Carcinoma with Pneumonia-like Infiltrative Shadow.

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A 70-year-old asymptomatic man was admitted to our hospital due to an increasing infiltrative shadow on the chest roentgenogram, which had been followed up for tenmonths. Chest roentgenogram and CT scan demonstrated pneumonia-like infiltrative shadow with air space consolidation containing bubble-like areas. Transbronchial lung biopsy yielded a diagnosis of interstitial pneumonia, and steroid therapy was initiated. However, the infiltrative shadow increased, therefore transbronchial lung biopsy was performed once more. Because the second one strongly implied the possibility of malignancy, exploratory thoracotomy and right lower lobectomy were performed. The specimen, the weight of which was 750g, was dark-red with a liver-like appearance, and was filled with abundant mucoid material. The columnar or cuboidal cells replaced the normal alveolar cells and were scattered along the alveoli and the bronchi throughout the right lower lobe. Pathologic diagnosis was bronchiolo-alveolar carcinoma (pT2NOMO) with mucin-producing cells. In this case, the tumor was limited to within one lobe and it was completely resected. Due to the difficulty of the preoperative diagnosis, about one year elapsed from when the first abnormality was recognized to surgical treatment. Careful follow-up is needed because of the possibility of transbronchial dissemination.
特定非営利活動法人日本肺癌学会の論文