Bronchoalveolar lung cancer is a fairly common oncopathology, which is characterized by the formation of multiple tumor-like small nodules.
The main site of this type of cancer is the alveolar-bronchial epithelial structures of the bronchial glands.
The most susceptible category of patients to cancer is middle-aged men and women.
How does bronchoalveolar cancer develop?
Pathogenesis, etiology
For the first time, oncopathology was described in 1876, when it was revealed during the autopsy of a female corpse. In Russian-language literature, mention of the disease appeared only in 1903. In the mid-1950s, an article was published that mentioned that the most common form of bronchoalveolar cancer was peripheral nodular cancer.
Currently, there is no reliable data on the causes of the development of any oncopathologies. Scientists have proven that there is a directcorrelation between genetic biotransformation of human DNA and this disease.
Exogenous and endogenous factors
Specialists identify a large number of exogenous and endogenous factors that contribute to the processes of changing genetic material:
- Age over 40.
- Localized pulmonary fibrosis.
- Passive or active smoking.
- Alcoholism.
- Bad environment.
- Systematic inhalation of vapors of toxic compounds - mercury, soot, mustard gas, coal dust, radon, ammonia, arsenic.
- Deficiency of trace elements, vitamins in the diet.
- Frequent development of inflammatory processes in the respiratory organs.
- Irrational nutrition (saturation of the diet with smoked foods, preservatives, trans fats).
- Changes in cicatricial character in lung tissues.
- Prolonged UV exposure.
- Reduced immune resistance of the body.
- Genetic predisposition.
- Living in man-made areas.
- Exposure to aromatic compounds for a long time.
- Lung damage from radiation.
Together, the above factors lead to damage to the genetic material, disruption of protein biosynthesis. As a result, abnormal peptides are formed that activate the reactions of apoptosis - biologically programmed cell death.
Decrease in metabolic reactions, the impact on the body of exogenous factorsorigin, the formation of endogenous carcinogens in combination with a violation of trophic innervation provoke the occurrence of a blastomatous process in the bronchi.
Pathological changes in a malignant neoplasm in the structure of the bronchi depend on the degree of lung obstruction. Pathological changes primarily develop when endobronchial growth of carcinoma begins.
Somewhat later, clinical manifestations occur with peribronchial tumor growth. The formation of a neoplasm leads to a violation of the anatomical structure of the lung and bronchial tissue, as a result of which the functionality of these organs is significantly complicated.
Hypoventilation
Generalization of the pathological process leads to the fact that hypoventilation develops against the background of bronchial obstruction. If the bronchus closes completely, atelectasis of a part of the lung is noted. In such situations, the paralyzed areas of the lung become more susceptible to infection. As a result of these pathological processes, lung gangrene or abscess often develops. Necrotic processes developing in the neoplasm are often the cause of pulmonary hemorrhage.
Localization of pathological foci
Pathological foci in BAD are localized in the peripheral areas of the lung. Nodular formations in cancer of this type have a dense texture, a grayish-white hue. The development of pathology leads to the emergence of multiple carcinogenic foci.
About40% of patients with bipolar disorder survive for 5 years. BAD is a highly differentiated adenocarcinoma. The parenchyma of a malignant neoplasm is built from atypical epithelial cells.
Clinical manifestations
In the initial stages, bronchoalveolar cancer does not manifest itself clinically. In some cases, without any reason, the patient develops a cough, accompanied by sputum production in large volumes (up to 4 liters per day), or a foamy liquid. With the course of the disease, shortness of breath develops, which is poorly amenable to therapy. The main atypical signs of oncopathology are:
- The occurrence of severe intoxication of the body.
- Development of pneumothorax.
- Excessive fatigue.
- Decreased appetite.
- Discomfort in the chest.
- Exhaustion.
- Dysfunctions of water-s alt metabolism.
- Increase in subfebrile temperature.
If a patient is diagnosed with an infiltrative or disseminated form of bronchoalveolar cancer, then the prognosis will be disappointing.
Stages
There are 4 stages of the disease:
- First. The size of the tumor reaches 5 cm, there are no distant metastases and lesions of regional lymph nodes.
- Second. The size of the tumor is 5-7 cm, the peribronchial and hilar lymph nodes are affected, the neoplasm grows into the pleura, diaphragm, and pericardium.
- The third stage of bronchoalveolar cancer. The tumor reaches a size of more than 7 cm, distant and regional lymph nodes are affected, the neoplasm grows into the mammary glands, heart, esophagus, trachea.
- Fourth. It is impossible to determine the size of the tumor. Secondary oncofoci are found in the brain, distant organs. The prognosis in this case is disappointing.
Diagnosis
Visual examination of the patient allows the doctor to detect cyanosis on the skin and visible mucous membranes, which is aggravated by physical exertion. Percussion examination reveals a shortened tone over pathological areas. In some cases, crepitus is heard. Laboratory blood tests for a long time show normal physiological results. With the progression of the pathology, an increased ESR, leukocytosis, and anemia are detected.
Bronchoalveolar cancer is very well diagnosed on CT. The patient is also prescribed MRI, ultrasound examination, radiography. With the help of bronchoscopy, it is possible to visually determine a malignant neoplasm, collect sputum, and perform a cytological examination.
CT diagnosis of bronchoalveolar lung cancer is the most informative technique.
With the help of endoscopic biopsy, specialists obtain biological material for further study of its histostructure. If the patient develops carcinomatous pleurisy, he is prescribed thoracocentesis, after which a cytological examination of the pleural effusion is performed.
Therapy
Therapybronchoalveolar cancer has certain features. To eliminate the cancer, surgery is used, after which radiation therapy is prescribed. There are currently no effective chemotherapy drugs for bipolar disorder.
BAR is generally considered to be a chemoresistant cancer. The sequence and combination of therapeutic methods is determined by the oncologist. He develops a therapy regimen individually for each patient.
If indicated, lobectomy and bilobectomy (partial resection of the lung), as well as its complete removal (pneumoectomy) are possible. The last procedure is indicated if the pathological process is generalized, there are metastases in the adjacent lymph nodes.
The main method of preventing BAD is preventive fluorography, the use of PPE in hazardous industries, the timely treatment of bronchitis, the rejection of bad habits.
A favorable prognosis for a lung disease such as bronchoalveolar cancer is possible with timely diagnosis of pathology, effective removal of foci at an early stage of carcinogenesis formation.
