Bronchiolo-alveolar cell carcinomas. A histopathologic analysis of 125 cases

A hundred and twenty-five cases of bronchiolo-alveolar cell carcinomas observed between 1954 and 1978 were histopathologically analysed, some of them also histoenzymatically. The material comprised 93 lung resections (56 lobectomies and 37 pulmonectomies). 11 intraoperatory biopsies in inoperable cases, and 21 autopsies. The early discovery and treatment of the overwhelming majority of cases allow the observation of uncomplicated lesions, the bronchiolar involvement followed by alveolar invasion due to sliding of neoplastic cells on denuded alveolar walls often thickened by cell and fibril accumulation, the papillary formations, as well as the histoenzymatic behaviour. The latter evidenced the strong relations of neoplastic cells with the normal bronchiolar cells (glucose-6-phosphate dehydrogenase. Mg-dependent ATP-ase, oxidoreductases). Some peculiarities also point to the existence of a possible second parallel origin of neoplastic cells at the level of large alveolocytes during the morphogenesis of this multicentric lung carcinoma.