1998 Volume 38 Issue 1 Pages 69-73
A 75-year-old man was admitted to our hospital because of multiple infiltrative shadows on a chest roentgenogram. Infiltrative shadows had progressed subacutely in comparison to the findings of 3 months previously. Chest CT scans demonstrated air space consolidation containing bubble-like areas. Sputum and bronchial washing cytology were negative. Bronchoalveolar lavage revealed an elevation of lymphocyte fraction. Open lung biopsy (OLB) was performed to make a distinction between idiopathic BOOP and other diseases. The specimen obtained by OLB histlogically revealed BOOP pattern in the bronchioles and alveolar ducts, showing granulation tissue with proliferation of fibroblasts, and bronchioloalveolar carcinoma with mucinproducing cells (BAC), in which small cystic spaces were observed with mucus in alveoli. We concluded that TBLB was important in the case of air space consolidation with bubble-like areas of low attenuation on the chest CT because mucin in the alveoli with or without malignant cells highly suggested BAC.
