Bronchioloalveolar carcinoma - A review of current concepts and evolving issues

Context.-The concept of bronchioloalveolar carcinoma underwent considerable refinement between the publications of the 1981 and 1999 World Health Organization classifications of lung tumors. Both pathologic and clinical aspects of this carcinoma are the subject of considerable interest. Objective.-To review and summarize the evolution of the current concept of bronchioloalveolar carcinoma and evolving issues that are under further investigation. Data Sources.-Pertinent peer-reviewed literature emphasizing historical classification and evolution as well as current and evolving concepts. Conclusions.-Small, solitary, nonmucinous bronchioloalveolar carcinomas are associated with a markedly better prognosis compared with conventional invasive adenocarcinomas. Such tumors may be cured by surgical resection and may be more responsive to epidermal growth factor receptor-targeted therapy. The prognosis and staging of multifocal disease remain unresolved, as does the question of whether a small amount of invasion adversely affects prognosis. Mucinous bronchioloalveolar carcinoma appears to be a markedly different entity than the nonmucinous subtype.