[Bronchiolo-alveolar cancer].

The bronchiolo-alveolar adenocarcinoma, less frequent than other types of bronchopulmonary cancers, occurs more frequently during pulmonary fibrosis. Besides a mucous bronchorrhea of little meaning, the clinical manifestations belong to the advanced stages. The X-ray, unreliable and variable, shows a variety of pictures from mono or multinodular ones to pseudopneumonic infiltrates. Usually no information could be derived from bronchoscopy. Positive cytological examination of sputum are unfrequent. Early surgery brings longer remissions than in other types of bronchopulmonary cancer. Diagnosis can only be made from the histology of the exeresis sample. The tumour cells, cuboidal or columnar, are arranged in mono or pluri-stratified layers in the inter-alveolar septa, which progressively become fibrous. This cancer has an original histogenesis: it would originate from the neoplastic metaplasia of type II pneumocytes or of respiratory bronchiole cells, invading the pulmonary alveoli by sliding or by contiguity. Far from the initial foyer, the spreading seems mostly done through airways.