Ultrastructural study of endogenous lipid pneumonia and pulmonary alveolar proteinosis coexistent with lung cancer.

The aim of the study was the ultrastructural analysis of endogenous lipid pneumonia (ELP)-type changes localized in the vicinity of primary neoplasms of the lungs. The analysis was carried out on the material obtained from 30 patients with non-small cell lung carcinoma (NSCLC). Routine histopathological examination was performed in light microscope, focusing mainly on the presence or lack of ELP-type changes. Ultrastructural examinations in transmission electron microscope used 12 cases classified among early (4 cases) or advanced (8 cases) ELP forms. Results of the study reveal a likely coexistence of ELP- and PAP (pulmonary alveolar proteinosis)-type changes in the vicinity of NSCLC and suggest a correlation between the processes leading to the development of ELP or/and PAP. Ethiopathogenesis of the changes observed and the role of granulocytes, macrophages and type II alveolar epithelial cells are discussed.