The Nightingale: I've got another case. She's in her 70's, she's frail. There it is. The radiology. See those three lesions? It's BAC. What do I do with that.
Bronchoalveolar carcinoma. Slow growing, and insidious. In pathology, we call the growth pattern lepidic. It grows along the alveolar parenchyma like a butterfly.
Rad: Is she a smoker?
The Nightingale: Yes, but. Her son blamed her condition on her smoking. I tried to tell him it's more complicated than that.
Ancient thoracic surgeon that smokes cigars in the doctor's parking lot: She's not going to die of that. Tell her to keep smoking. I'd keep smoking if I had that diagnosis.
Rad: I only worry about her lung capacity. You say she is frail. These things can percolate for years, then they get bigger.
Ancient surgeon: Yeah, I'd follow her every six months with radiology.
Rad: Is she a candidate for SBRT?
Stereotactic body radiation therapy.
The Nightingale: I could offer her that. Absolutely. But right now, watch and wait, right? That's the consensus? Next case?
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