DISTINCTION OF CONSOLIDATIVE BRONCHIOLOALVEOLAR CARCINOMA FROM PNEUMONIA - DO CT CRITERIA WORK

OBJECTIVE. The purpose of this study was to compare the CT findings of consolidative bronchioloalveolar carcinoma (BAC) with consolidative i nfectious pneumonia and determine if any pattern revealed by CT is mor e specific for one disease than the other and may therefore expedite a diagnosis of consolidative BAC using CT. MATERIALS AND METHODS. The C T findings in 20 patients with consolidative BAC and 20 patients with consolidative infectious pneumonia were reviewed. Radiologic features included the presence and distribution of consolidation, nodules, and ground-glass opacities; the presence of air bronchogram, mucous bronch ogram, contrast enhancement, cysts, or cavities within the consolidati on; and pulmonary fibrosis or significant parenchyma scarring. RESULTS . Statistically significant (p <.003) findings that were more often se en on CT scans of patients with consolidative BAC than on those of pat ients with consolidative pneumonia included coexisting nodules (p <.00 1) and a peripheral distribution of consolidation (p <.001). CONCLUSIO N. When nonresolving peripheral consolidative pneumonia, especially wi th associated nodules, is shown on CT, radiologists should suspect BAC when the patient is an adult with normal immunity.