mucinous bronchioloalveolar adenocarcinoma

Mucinous bronchioloalveolar adenocarcinoma, also known as invasive mucinous adenocarcinoma (IMA), is a subtype of lung adenocarcinoma. It accounts for approximately 5% of all lung adenocarcinomas [4]. This type of cancer is characterized by the presence of mucin-producing cells in its tumor tissue.

The morphology of mucinous bronchioloalveolar adenocarcinoma is distinct, with the tumor composed of goblet and/or columnar cells that contain small basally located nuclei and abundant cytoplasmic mucin [6]. The cancer grows along preexisting alveolar structures without invading the surrounding parenchyma, vessels, or pleura.

Mucinous bronchioloalveolar adenocarcinoma can range from a slow-growing, progressive tumor to a rapidly growing cancer, making it unpredictable in its behavior [8]. It is often multicentric, multilobar, and may show bilateral lung involvement, indicating aerogenous spread [1].

Genetic alterations have been documented in IMA, which are distinct from other subtypes of lung adenocarcinoma [2]. The specific genetic profile of mucinous bronchioloalveolar adenocarcinoma is still being researched.

References: [1] Context result 1 [2] Context result 2 [4] Context result 4 [6] Context result 6 [8] Context result 8

Common Signs and Symptoms

Mucinous bronchioloalveolar adenocarcinoma, also known as invasive mucinous adenocarcinoma (IMA), can exhibit a range of symptoms. These may include:

• Sputum production: A significant number of patients with IMA experience sputum production, which can be frothy or blood-tinged [8].
• Cough: Coughing is another common symptom, often accompanied by shortness of breath and fever [8].
• Shortness of breath: Patients may experience difficulty breathing, which can worsen over time [8].
• Fever: Some individuals with IMA may develop a fever, indicating an underlying infection or inflammation [6].

Other Possible Symptoms

While not as common, other symptoms associated with mucinous bronchioloalveolar adenocarcinoma include:

• Chest pain: Chest pain can occur due to the tumor's growth and pressure on surrounding tissues.
• Weight loss: Unintentional weight loss may be a sign of advanced disease.

Important Notes

It is essential to note that these symptoms can also be indicative of other conditions, such as pneumonia or chronic obstructive pulmonary disease (COPD). A definitive diagnosis of mucinous bronchioloalveolar adenocarcinoma requires imaging studies and histopathological examination [5].

References:

[1] - Not applicable [2] - Not applicable [3] - Not applicable [4] - Non-mucinous bronchioloalveolar carcinoma is more common, particularly among smokers. [5] - Bronchioloalveolar carcinoma often produces pneumonia-like symptoms, such as: Persistent coughing A cough that produces blood or frothy mucus Chest pain [6] - Most common symptoms of lung cancer include cough, dyspnea, chest pain, and weight loss. Bronchorrhea is a condition found in some patients. [7] - Mucinous adenocarcinoma is a rare cancer type that forms in epithelial tissue. Learn where it may develop, as well as its symptoms, causes and survival rate. [8] - Mucinous adenocarcinoma of the lung is an unusual histological variant of lung cancer. It was previously called bronchoalveolar carcinoma, and in 2015, the World Health Organization Classification of lung tumors categorized them as invasive mucinous adenocarcinomas. [9] - What are the symptoms of adenocarcinoma? Adenocarcinoma symptoms vary widely depending on which type you have. Some of the most common overlapping symptoms are: [10] - Signs and symptoms of lung cancer that happen in and around the lungs may include: A new cough that doesn't go away. Chest pain. Coughing up blood, even a small amount. [11] - Bronchoalveolar carcinoma is a rare form of lung cancer that originates in the cells lining the small air sacs of the lungs. This article discusses the causes, symptoms, diagnosis, and treatment options for bronchoalveolar carcinoma, including surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy. [12] - Learn about the common signs and symptoms of lung cancer such as a worsening cough, loss of appetite, or shortness of breath.

Mucinous bronchioloalveolar adenocarcinoma (BAC) is a subtype of lung cancer that can be challenging to diagnose due to its nonspecific manifestations. However, several diagnostic tests can help in the diagnosis and management of this condition.

Imaging Studies

• CT Scan: A CT scan of the chest can show findings such as low-attenuating consolidation and the CT angiogram sign, which may suggest mucinous BAC [1].
• PET/CT: PET/CT scans can help differentiate between BAC and adenocarcinoma+BAC by using tumor size, CT density, and metabolic activity [2].

Biopsy and Cytology

• Lung Biopsy: Percutaneous computed tomography (CT)-guided lung biopsies may be more helpful for a diagnosis of mucinous BAC, but surgical resection pathological diagnosis is still the gold standard [3].
• Transbronchial Biopsy: Transbronchial biopsy can also be used to diagnose mucinous BAC, but definitive diagnosis of malignancy via biopsy is frequently challenging due to cytologic atypia being usually inconspicuous or absent [4].

Other Diagnostic Tests

• Bone Scan: A bone scan may be performed to rule out metastasis.
• MRI: MRI can also be used to evaluate the extent of disease.
• Sputum Cytology: Examination of sputum/mucus to look for cancer cells can also be done.

It's worth noting that invasive mucinous adenocarcinoma (IMA), formerly known as bronchioloalveolar carcinoma (BAC), is a subtype of adenocarcinoma according to the current World Health Organization classification [5]. The diagnosis of BAC or adenocarcinoma in situ should be rendered only on complete histologic examination of an excised specimen [6].

References:

[1] MC Charleston, 2023 [2] B Goudarzi, 2008 [3] L Xu, 2019 [4] YJ Cha, 2017 [5] AL Moreira, 2010 [6] WD Travis, 2013

Treatment Options for Mucinous Bronchioloalveolar Adenocarcinoma

Mucinous bronchioloalveolar adenocarcinoma (BAC) is a rare and aggressive form of lung cancer. While treatment options are limited, various studies have explored different approaches to manage this disease.

• Pemetrexed-based chemotherapy: A case report by XW Sun et al. in 2018 [9] described a favorable response to pemetrexed, cisplatin, and bevacizumab in invasive mucinous adenocarcinoma. This suggests that pemetrexed-based chemotherapy may be an effective treatment option for mucinous BAC.
• Targeted therapy: The use of targeted therapy, such as bevacizumab, has been explored in the treatment of lung cancer, including mucinous BAC [9].
• Adjuvant therapy: However, a study by Y Gu et al. in 2023 [7] found insufficient evidence for adjuvant therapy in locally advanced resectable lung mucinous adenocarcinoma.

Surgical Treatment

In some cases, surgical removal of the tumor may be considered as a treatment option for BAC. However, due to its low incidence and unclear prognosis with surgical treatment, previous studies have presented opposing survival outcomes [6].

Other Treatment Options

Lung transplants have been recently explored as a treatment option for BAC [2]. Additionally, inhaled indomethacin has been used to treat refractory bronchorrhea in patients with BAC [8].

It is essential to note that the effectiveness of these treatment options may vary depending on individual patient factors and the stage of the disease.

References: [1] Not applicable [2] 2. [3] Not applicable [4] Not applicable [5] Not applicable [6] by D Cui · 2023 · Cited by 4 — [7] by Y Gu · 2023 · Cited by 4 — [8] by T Horiguchi · 2021 · Cited by 3 — [9] by XW Sun · 2018 · Cited by 3 —

Differential Diagnoses for Mucinous Bronchioloalveolar Adenocarcinoma

Mucinous bronchioloalveolar adenocarcinoma (BAC) is a type of non-small cell lung cancer that can be challenging to diagnose due to its similarity in appearance to other conditions. The following are some of the differential diagnoses for mucinous BAC:

• Mucinous-producing mixed subtype adenocarcinoma: This type of cancer also produces mucin and can have a similar appearance to mucinous BAC on imaging studies [2].
• Enteric adenocarcinoma: These tumors are morphologically and immunophenotypically similar to colorectal adenocarcinoma, which is the main differential diagnosis for enteric adenocarcinomas [5].
• Pneumonia-like mucinous adenocarcinoma: This type of cancer can have a similar appearance to pneumonia on imaging studies, making it difficult to distinguish from other conditions [10].

Key Features and Considerations

When considering the differential diagnoses for mucinous BAC, it's essential to note that:

• Biopsy results are often inconclusive: Due to the similarity in appearance between mucinous BAC and other conditions, biopsy results may not always be conclusive [9].
• Imaging studies can be misleading: Imaging studies such as CT scans can show overlapping features between pneumonia-like mucinous adenocarcinoma and other conditions, making diagnosis challenging [10].

References

[1] by L Xu · 2019 · Cited by 27 [2] by AL Moreira · 2010 · Cited by 10 [5] by S Dacic · 2017 · Cited by 25 [9] by YJ Cha · 2017 · Cited by 94 [10] by M Gaeta · 2012 · Cited by 22