Bronchoalveolar lung cancer is a fairly common cancer pathology, which is characterized by the formation of multiple tumor-like small nodules.
The main place of localization of this type of cancer is the alveolar-bronchial epithelial structure of the bronchial glands.
The most susceptible category of cancer patients is middle-aged men and women.
How does bronchoalveolar cancer develop?
Pathogenesis, etiology
Oncopathology was first described in 1876, when it was identified during an autopsy of a female corpse. In Russian-language literature, mention of the disease appeared only in 1903. An article was published in the mid-1950s that mentioned that the most common form of bronchoalveolar cancer is peripheral nodular.
Currently, reliable data on the causes of the development of any cancer pathology is not available. Scientists have proven that there is a direct correlative relationship between the 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 the genetic material:
- Age from 40 years.
- Localized pneumofibrosis.
- Passive or active smoking.
- Alcoholism.
- Bad ecology.
- 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 products, preservatives, trans fats).
- Changes in the cicatricial nature in the lung tissue.
- Long exposure to ultraviolet radiation.
- Decreased immune resistance of the body.
- Genetic predisposition.
- Living in industrial areas.
- Exposure to aromatic compounds for a long time.
- Damage to the lungs by radiation.
Together, the above factors lead to damage to the genetic material, a violation of protein biosynthesis. As a result, abnormal peptides are formed that activate the reactions of apoptosis, a biologically programmed cell death.
A decrease in metabolic reactions, the influence of exogenous factors on the body, the formation of endogenous carcinogens in combination with a violation of trophic innervation provoke the appearance of a blastomatous process in the bronchi.
Pathomorphological changes in malignant neoplasms in the structure of the bronchus depend on the degree of lung obstruction. Pathological changes primarily develop when the endobronchial growth of carcinoma begins.
A little 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 development of hypoventilation 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 BAR are localized in the peripheral regions of the lung. Nodular formations in this type of cancer have a dense texture, a grayish-white hue. The development of pathology leads to the appearance of multiple carcinogenic foci.
Approximately 40% of patients with BAD 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, for no reason, the patient develops a cough, accompanied by the release of sputum in large volumes (up to 4 liters per day), or a foamy character. During the course of the disease, shortness of breath develops, poorly responding to therapy. The main atypical signs of oncopathology are:
- The occurrence of severe intoxication of the body.
- The development of pneumothorax.
- Excessive fatigue.
- Decreased appetite.
- Discomfort in the chest.
- Exhaustion.
- Dysfunction of water-salt metabolism.
- Increased subfebrile temperature.
If a patient is diagnosed with an infiltrative or disseminated form of bronchoalveolar cancer, the prognosis will be disappointing.
Stages
There are 4 stages of the disease:
- First one. The tumor size reaches 5 cm, distant metastases and lesions of regional lymph nodes are absent.
- The second one. The tumor size is 5-7 cm, peribronchial and basal lymph nodes are affected, the neoplasm grows into the pleura, diaphragm, 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 in the mammary glands, heart, esophagus, trachea.
- Fourth. It is impossible to determine the size of the tumor. Secondary cancer sites are found in the brain, distant organs. The forecast in this case is disappointing.
Diagnostics
A visual examination of the patient allows the doctor to identify cyanosis on the skin and visible mucous membranes, intensifying during physical exertion. Percussion examination allows you to detect a shortened tone over pathological areas. In some cases, crepitus is heard. Laboratory tests of blood for a long time show normal physiological results. With the progression of pathology, an increased ESR, leukocytosis, and anemia are detected.
CT scan of bronchoalveolar cancer is very well diagnosed. The patient is also prescribed MRI, ultrasound, radiography. Using bronchoscopy, it is possible to visually determine a malignant neoplasm, carry out sputum collection, and perform a cytological examination.
CT diagnostics of bronchoalveolar lung cancer is the most informative technique.
Using an endoscopic biopsy, specialists obtain biological material for subsequent examination 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
Therapy of bronchoalveolar cancer has certain features. To eliminate cancer, they use surgical intervention, after which radiation therapy is prescribed. There are currently no effective medicines for chemotherapy for BAD.
It is believed that BAR is chemoresistant cancer. The order and combination of therapeutic methods is determined by the oncologist. He develops a therapy regimen individually for each patient.
If there is evidence, lobectomy and bilobectomy (partial resection of the lung), as well as its complete removal (pneumectomy) are possible. The last procedure is indicated if the pathological process is generalized, metastases are present in the adjacent lymph nodes.
The main method for preventing BAR is prophylactic fluorography, the use of PPE in harmful industries, timely treatment of bronchitis, and abandonment 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.