Ten patients with proved Bronchiolo-alveolar cell carcinoma were found in a series of 232 patients with primary lung cancer who were seen in the Chest Department of the National Medical Center from 1975-1980, an incidence of 4.3 percent among total primary lung cancer patients.
1) The ratio of male and female was 1：1. The highest incidence (3 of 10 cases) was seen in the sixth decade, and the remaining cases were evenly distributed in the third, fourth, and fifth decades of life. Among them, the youngest was 29 years old and the oldest 66 years of age.
2) The most common symptoms were cough and mucoid sputum, being 6 and 4 cases respectively, 2 of whom expectorated as much as 300㎖ to 400㎖ of sputum daily. Three others presented with chest pain, three with hemoptysis, and one with hoarseness.
3) Initial diagnoses and management prior to the final diagnosis were as follows; pulmonary tuberculosis (6 cases), pneumonia (1 case), bronchiectasis (1 case), and lung cancer (2 cases).
4) The tumors presented several different radiologic pictures; most commonly, homogeneous or patchy infiltrations, next commonly, nodular or mass-like density, partial pneumothorax (2 cases), and pleural effusion (2 cases). Bronchograms revealed no contributable findings except one case of complete tapering obstruction of the segmental bronchus.
5) The diagnosis was established in all cases; 4 from sputum cytology, 1 from pleural fluid cytologic test, 1 from regional lymph node biopsy 1 from percutaneous lung biopsy, 2 from open lung biopsy, and 3 from surgery.
6) Seven of our cases were considered inoperable at the time of admission; these have all died within 2 to 10 months after diagnosis. In contrast, 3 patients showed operable lesions and surgery was performed; two are still living, one without regional lymph node metastasis over 3 years well, the other with regional lymph node metastasis over 1 year worse, and a third survived 2 months before succumbing. It can be appreciated that survival time was much longer in operative cases than in nonoperative ones. Therefore we arrive at the conclusion that diagnosis earlier in the natural history of the disease will result in increased resectability and improved survival and that aggressive diagnostic work-up for suspicious pulmonary infiltrate is imperative as early surgery offers the only cure.
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