Mucinous Adenocarcinoma or Adenocarcinoma in Situ, Diffuse Form

Fig. 20.9 Diffuse nonmucinous adenocarcinoma in situ in a 70-year- old woman. (a, b) Lung window images of CT scans (2.5-mm section thickness) obtained at levels of right bronchus intermedius (a) and right inferior pulmonary vein (b), respectively, show patchy extensive areas

of ground-glass opacity having internal reticulation (crazy-paving appearance, arrows) in both lungs. (c, d) Ten-month follow-up CT scans obtained at similar levels to a and b, respectively, demonstrate progressive disease with diffuse ground-glass opacity in both lungs

CT–Pathology Comparisons

Areas of GGO represent alveolar Þlling with Þnely granular eosinophilic materials. Crazy-paving appearance results from septal edema or from accumulation of lipoproteins in the airspaces adjacent to normal interlobular septa [22].

Patient Prognosis

care. Novel therapy targeting alveolar macrophage with granulocyte-macrophage colony-stimulating factor is now considered an alternative to whole lung lavage.

Mucinous Adenocarcinoma or Adenocarcinoma in Situ, Diffuse Form

Pathology and Pathogenesis

From spontaneous remission to death, disease evolution is unpredictable. Acquired pulmonary alveolar proteinosis has been treated successfully since 1960s by whole lung lavage, and this procedure remains the standard of

Invasive mucinous adenocarcinoma (formerly mucinous BAC) has a distinctive histologic appearance with tumor cells having a goblet or columnar cell morphology with abundant intracytoplasmic mucin. Cytologic atypia is usually incon-