Cytological, Radiological and Pathological Examination of Bronchioloalveolar Type Adenocarcinoma that Possess Hardly any Fibrotic Focus nor Invasive Cancer Tissue (Recent Progress in the Diagnosis and Treatment of Lung Cancer)

Twenty four cases of bronchioloalveolar type adenocarcinoma that possess hardly any fibrotic focus nor invasive cancer tissue were examined cytologically, pathologically and radiologically. The 24 cases were classified into four subgroups, group I：most of tumor cells were similar to type II alveolar epithelium, group II：most of tumor cells to Clara cell, group III：most of tumor cells to goblet cell and group IV：other. At the center of group I and IV tumor, tumor cells showed severe nuclear atypism and heaping up proliferation pattern. But the peripheral area of tumor resemble atypical alveolarcuboidal cell hyperplasia (AACCH). Heaping up proliferation pattern was observed in all area of group II tumor and in 6 cases, AACCH-like lesion was associated. We consider the following criteria to be important in making a cytological diagnosis. 1) Type I and IV carcinoma：Cells that have nuclei larger than 52 μ^2 and are smilar to alveolar epithelium. 2) Type II carcinoma：Cluster that contain a number of closely packed cells that resemble Clara cell. 3) Type III carcinoma：Cells that are arrenged in a honey-comb appearance or closely packed cells with nuclear palisading at the base of columnar cells. Cell types were closely related with pathological pattern and the pathological pattern was well reflected on radiological findings. Correlation of cytological findings with the results of radiological examination is essential for accurate diagnosis