Re: Bronchiolo-alveolar lung cancer: occurrence, surgical treatment and survival^☆ Free

Furák et al. [1] provide interesting data on bronchiolo-alveolar (BAC) lung cancer: occurrence, surgical treatment and survival; however, their pathological classification [2,3] as to what constitutes a BAC is not the current World Health Organization (WHO) definition [4].

Furák et al. defined BAC as an adenocarcinoma if more than 50% of the adenocarcinoma had a BAC component. The WHO classifies an adenocarcinoma with a BAC component as ‘adenocarcinoma mixed type with predominant bronchioloalveolar pattern’, regardless of the percentage of the BAC component. Most tumours described as BAC in the past would now be in this category. The present definition of BAC is much more restrictive than any previously used by many pathologists.

In addition, Furák et al. subdivided BAC into three types: (1) non-mucinous; (2) mucinous; and (3) mixed mucinous and non-mucinous or undetermined. Unfortunately, their failure of classification as to what is a BAC made them conclude that mucinous and non-mucinus (Clara type II cell origin) BACs have the same survival, when it is well known that non-mucinous are usually solitary nodules and have very good prognosis [4].

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