Alveolar Cell Carcinoma

• Associated with scleroderma and or local scarring or fibrosis
• Growth may be very slow (7-12 years)
• Histologically, they may appear identical to a metastatic adenoca from elsewhere
• They all probably begin from a single abnormal cell
• Lymphatic involvement is common

X-ray

  • Local (more common)
        • Mass containing air bronchogram
                • DDx: Lymphoma, pseudolymphoma, inflammatory pseudotumor
                • Commonly have participating tail of atelectasis to pleura

• Diffuse
        • May be discrete or represent an area of consolidation
        • Effusion in 10%

• Symptoms
   • About 50% are asymptomatic—symptoms include cough especially , sometimes very productive (up to 4 liters a day=bronchorhea)