[Bronchioloalveolar carcinoma: an exceptional cause of diffuse lung disease in a patient with acute myeloid leukemia].
Fiche publication
Date publication
mars 2014
Auteurs
Membres identifiés du Cancéropôle Est :
Pr VIGNAUD Jean-Michel
Tous les auteurs :
Boubaya A, Gomez E, Guerder A, Ropion-Michaux H, Kheir A, Vignaud JM, Chaouat A, Chabot F
Lien Pubmed
Résumé
INTRODUCTION: Bronchiolo-alveolar carcinoma is a primary pulmonary adenocarcinoma developing in the terminal respiratory unit. CASE REPORT: An 84-year-old non-smoker woman with a history of untreated acute myeloid leukaemia was referred to the intensive care unit for pneumonia and acute respiratory failure. The patient reported dyspnoea and a productive cough for 3 months, treated by antibiotics and steroids without improvement. Thoracic CT-scan showed alveolar condensations and multiple nodular lesions. All microbiological samples were negative and the evolution was fatal within 72 hours despite empirical antibiotic therapy and noninvasive ventilation. Post-mortem lung biopsies gave a diagnosis of mucinous and non-mucinous bronchiolo-alveolar carcinoma with typical lepidic growth pattern of tumor cells and discrete septal thickening but no fibrosis, inflammation or local invasion. CONCLUSION: Bronchiolo-alveolar carcinoma is an alternative diagnosis in alveolar condensations associated with pulmonary nodules even in a patient with immunosupression. Early diagnosis allows effective treatment in some cases.
Référence
Rev Mal Respir. 2014 Mar;31(3):259-62