History: 67 yo female with chronic productive cough
Solution: Bronchioalveolar carcinoma
Bronchioalveolar carcinoma is generally considered a subtype of adenocarcinoma and has three typical radiologic patterns. A solitary nodule is the most frequent manifestation. These nodules are often hazy and ill-defined. The tumor grows along the alveolar walls, and this likely explains their relative lack of density on radiographic studies. The second most common radiographic appearance is pneumonia-like consolidation (20%). This appearance can be associated with nodules as well. The final appearance is what we see in this case, which is multiple nodules scattered througout both lungs, associated with areas of ground glass attenuation and consolidation. The nodules are usually around 5 mm in diameter and often have a very irregular border. This particular presentation is relatively uncommon, but fairly characteristic when present. Prognosis is relatively good for patients with limited disease or solitary nodues, but is dismal with diffuse disease.
Characteristic symptom is bronchorrhea, which is a watery abundant white mucoid expectorate that can result in hypovolemia and electrolyte depletion. This symptom is only seen in the diffuse form.
Bronchioalveolar carcinoma is generally considered a subtype of adenocarcinoma and has three typical radiologic patterns. A solitary nodule is the most frequent manifestation. These nodules are often hazy and ill-defined. The tumor grows along the alveolar walls, and this likely explains their relative lack of density on radiographic studies. The second most common radiographic appearance is pneumonia-like consolidation (20%). This appearance can be associated with nodules as well. The final appearance is what we see in this case, which is multiple nodules scattered througout both lungs, associated with areas of ground glass attenuation and consolidation. The nodules are usually around 5 mm in diameter and often have a very irregular border. This particular presentation is relatively uncommon, but fairly characteristic when present. Prognosis is relatively good for patients with limited disease or solitary nodues, but is dismal with diffuse disease.
Characteristic symptom is bronchorrhea, which is a watery abundant white mucoid expectorate that can result in hypovolemia and electrolyte depletion. This symptom is only seen in the diffuse form.
CT Images
