High-resolution CT findings of diffuse bronchioloalveolar carcinoma in 38 patients.
OBJECTIVE
The purpose of this study was to analyze the high-resolution CT features of diffuse bronchioloalveolar carcinoma and determine the useful findings in differential diagnosis.


METHODS
High-resolution CT scans of 38 patients with pathologically proven diffuse bronchioloalveolar carcinoma were reviewed. Sequential CT scans were obtained in 15 patients. The high-resolution CT findings were compared with those of eosinophilic pneumonia (n = 22), multiple pulmonary metastases (n = 12), and tuberculosis (bronchogenic: n = 22; miliary: n = 12).


RESULTS
High-resolution CT findings of diffuse bronchioloalveolar carcinoma included ground-glass opacity (n = 29), consolidation (n = 29), nodules (n = 28), centrilobular nodules (n = 26), peripheral distribution (n = 19), and air bronchogram (n = 18). According to the major features, high-resolution CT findings of diffuse bronchioloalveolar carcinoma could be classified into three patterns: predominantly ground-glass (n = 4), consolidative (n = 22), and multinodular (n = 12). Most patients with diffuse bronchioloalveolar carcinoma had a mixture of these findings. The frequency of findings of diffuse bronchioloalveolar carcinoma on high-resolution CT was not different from that of tuberculosis, but the predominant distribution of the nodules and areas of ground-glass attenuation differed between the two. Difference in distribution between bronchioloalveolar carcinoma and bronchogenic tuberculosis included ground-glass opacity remote from the consolidation and a lower lung predominance.


CONCLUSIONS
Although these high-resolution CT findings are not specific, the combination of consolidation and nodules and the coexistence of centrilobular nodules and remote areas of ground-glass attenuation are characteristic of diffuse bronchioloalveolar carcinoma.
Akira
M
M
Department of Radiology, National Kinki Chuo Hospital for Chest Disease, Sakai City, Osaka, Japan.
Atagi
S
S
Kawahara
M
M
Iuchi
K
K
Johkoh
T
T
D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011657:Pulmonary Eosinophilia / Q000000981:diagnostic imaging / Q000473:pathology; D011856:Radiographic Image Enhancement; D014057:Tomography, X-Ray Computed; D014376:Tuberculosis / Q000000981:diagnostic imaging / Q000473:pathology