0
Articles |

Analysis of Cell Type and Radiographic Presentation as Predictors of the Clinical Course of Patients With Bronchioloalveolar Cell Carcinoma

Kurt H. Albertine; Robert M. Steiner; Daniel M. Radack; Daniel M. Golding; Donald Peterson; Herbert E. Cohn; John L. Farber
Author and Funding Information

Affiliations: From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Departments of Medicine and Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia; and the Department of Medicine of the Lankenau Hospital, Wynnewood, Pa.,  From the Department of Surgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Pathology, Jefferson Medical College of Thomas Jefferson University, Philadelphia

Affiliations: From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Departments of Medicine and Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia; and the Department of Medicine of the Lankenau Hospital, Wynnewood, Pa.,  From the Department of Surgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Pathology, Jefferson Medical College of Thomas Jefferson University, Philadelphia

Affiliations: From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Departments of Medicine and Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia; and the Department of Medicine of the Lankenau Hospital, Wynnewood, Pa.,  From the Department of Surgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Pathology, Jefferson Medical College of Thomas Jefferson University, Philadelphia

Affiliations: From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Departments of Medicine and Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia; and the Department of Medicine of the Lankenau Hospital, Wynnewood, Pa.,  From the Department of Surgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Pathology, Jefferson Medical College of Thomas Jefferson University, Philadelphia

Affiliations: From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Departments of Medicine and Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia; and the Department of Medicine of the Lankenau Hospital, Wynnewood, Pa.,  From the Department of Surgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Pathology, Jefferson Medical College of Thomas Jefferson University, Philadelphia

Affiliations: From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Departments of Medicine and Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia; and the Department of Medicine of the Lankenau Hospital, Wynnewood, Pa.,  From the Department of Surgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia,  From the Department of Pathology, Jefferson Medical College of Thomas Jefferson University, Philadelphia


1998 by the American College of Chest Physicians


Chest. 1998;113(4):997-1006. doi:10.1378/chest.113.4.997
Text Size: A A A
Published online

Abstract

Study objectives: Bronchioloalveolar carcinoma is a primary lung neoplasm of variable histopathologic, radiologic, and clinical expression. There are three cell types described in bronchioloalveolar carcinoma: Clara cells, mucin-producing cells, and alveolar type II epithelial cells. It is unclear whether these three tumor cell types are associated with a specific radiologic presentation and clinical course. In this study, we investigated whether tumor cell type, identified by transmission electron microscopy, correlated with a specific radiologic pattern, and whether tumor cell type or radiologic presentation correlated with the patient's clinical course and outcome.

Design: Transmission electron microscopy was used to restudy tissue blocks from the original surgical histopathologic specimens in 54 patients with primary bronchioloalveolar carcinoma diagnosed over a 10-year period (1980 to 1990). The pretreatment radiographs were reviewed in each case, and the first chest radiograph obtained at the time of the discovery of the tumor in each patient was compared with the results of the ultrastructural study. The medical records of each patient were examined to obtain pertinent radiologic, clinical, and patient outcome information.

Measurement and results: There were 32 Clara cell tumors, 10 mucin-producing cell tumors, and 1 alveolar type II epithelial cell tumor in this series. Eleven additional tumors had mixtures of two or more cell types. No statistically significant relationship was detected between tumor cell type and radiologic presentation or patient mortality pattern. There was increased mortality among patients who presented radiologically with segmental, lobar, multifocal, or diffuse disease compared with those patients exhibiting a solitary pulmonary nodule at presentation.

Conclusion: Radiologic presentation, rather than tumor cell type, provides prognostic information that aids in predicting patient outcome.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Topics

carcinoma

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543