CT differentiation of solitary from diffuse bronchioloalveolar carcinoma

The therapy and prognosis of bronchioloalveolar carcinoma vary greatly with the solitary versus the diffuse form of the disease. Solitary disease demonstrates a high resectability rate with good long term prognosis. This contrasts with the rapidly fatal course associated with the diffuse form. To date, categorization of patients into either the solitary or the diffuse form has been based solely on conventional radiography. Multiple authors have reported cases of disease not demonstrated radiographically but discovered at surgery or autopsy. With the superiority of chest computed tomography (CT) for demonstrating parenchymal abnormalities, we propose that preoperative CT may be crucial in the workup of patients with presumed solitary bronchioloalveolar cell carcinoma. Early identification of diffuse disease or confirmation of the presence of solitary disease by CT may allow the institution of proper therapy and better evaluation of patient prognosis.