Carles P, Fabre J, Des E, Aldegheri C, Lauque D, Berthoumieu F, Dahan M
Service de Médecine, Hôpital de Purpan, Toulouse.
Rev Pneumol Clin. 1989;45(2):64-70.
Thirty-eight cases of bronchioloalveolar carcinoma were selected on anatomico-pathological criteria and analysed both radioclinically and histologically. At histology, this type of carcinoma is characterized chiefly by the growth of malignant cells along the alveolar walls. Cytology, which determines the nature of these cells (pneumocyte II or Clara cell), is not specific but remains important as regards phylogenesis. The course of bronchioloalveolar carcinoma gives a better understanding of its mode of propagation. Actuarial curves show that all patients with a diffuse carcinoma die very rapidly, whereas the survival rate of those who have localized lesions is 60% at 5 years. Moreover, the time required for dissemination to take place is long in assessable cases. This means that the condition should be diagnosed at an early stage on the presence of crepitant rales, on their air bronchogram at CT and on transparietal needle biopsy under CT. The chances are that early excision will result in cure.
根据解剖病理学标准选取了38例细支气管肺泡癌病例，并对其进行了放射临床和组织学分析。在组织学上，这类癌主要表现为恶性细胞沿肺泡壁生长。确定这些细胞（II型肺细胞或克拉拉细胞）性质的细胞学检查虽不具有特异性，但在系统发生方面仍很重要。细支气管肺泡癌的病程有助于更好地理解其扩散方式。精算曲线显示，所有弥漫性癌患者死亡速度极快，而局限性病变患者的5年生存率为60%。此外，在可评估的病例中，发生扩散所需的时间较长。这意味着应根据存在的捻发音、CT上的空气支气管造影以及CT引导下经皮穿刺活检来早期诊断该病。早期切除有可能治愈。
