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Cytopathologic
diagnosis of pulmonary neoplasms in sputum and bronchoscopic specimens.
Semin
Diagn Pathol. 1986 Aug;3(3):188-95
Cytopathologic techniques have been used for the detection and diagnosis
of pulmonary neoplasms for many years. Cytopathologic examination of
sputum is the most effective method for the detection of early squamous
cell carcinoma, but it is not effective for diagnosing peripheral
neoplasms, such as adenocarcinomas, in their early stages. Advanced
neoplasms of any type, however, can be diagnosed in sputum. The
cytopathologic examination of bronchoscopically obtained specimens is a
valuable adjunct to biopsies in visible lesions. In addition, it may
provide the only microscopic diagnosis in certain peripheral tumors or
help in the localization of radiologically occult carcinomas detected by
sputum cytology. Although cytopathologic diagnosis of cancer is highly
accurate, certain benign conditions can mimic cancer and care must be
taken in their interpretation. The type of neoplasm can be accurately
diagnosed in well-differentiated carcinomas and small cell carcinomas but
less accurately in poorly differentiated and large cell carcinomas.
Utilization of proper collection and preparation techniques is crucial for
optimal cytopathologic diagnosis.
The value of
cytology in the diagnostics of lung cancer.APMIS.
2005 Mar;113(3):208-12.
In order to elucidate the relative contributions made by cytology and
histology in the diagnosis of lung cancer, we studied the cytology and
histology reports of all patients who received a microscopic diagnosis of
lung cancer in our hospital during the 7 years 1996-2002. This gave a
total of 407 patients. The most frequent diagnoses were squamous cell
carcinoma (34.9%), adenocarcinoma (24.8%), and small cell carcinoma
(17.8%). One hundred and fifteen patients (28.3%) received their
microscopic diagnosis based only on cytology, which therefore proved to be
of great diagnostic value. The most useful type of cytology specimen was
taken by bronchial lavage or bronchial brushing. These types of specimens
provided the diagnosis in 71 patients (17.4%). Cytology was especially
capable of finding squamous cell carcinomas. Small cell carcinomas were
underrepresented (9.6% versus 17.8%) and unspecified carcinomas greatly
overrepresented (9.6% versus 2.9%) among the diagnoses obtained by
cytology alone. We conclude that cytology is of considerable diagnostic
value, although not as specific as histology for the subtyping of
carcinomas. Clinicians should be more aware of the usefulness of cytology,
especially in cases where it is difficult to obtain bronchoscopic biopsy
samples for histological examination.
Correlations between the
results of the histological and cytological examination in the diagnostic
of the broncho-pulmonary cancer.Rom
J Morphol Embryol. 2005;46(4):311-5
INTRODUCTION: Within the last years one discusses more and more about the
association of the cytological examination with the histological one,
becoming an important complementary examination. Casebook record. 163
patients were taken in the study, age between 37-79 years old, who showed
clinical and radiological signs of broncho-pulmonary cancer. At all the
patients a fibro-bronchoscopic examination was performed, with harvesting
of material for histological and cytological examination. MATERIAL AND
METHODS: The histological examination was performed on bioptic pieces,
fixed with 10% formalin and colored with Hematoxylin-Eosin, Masson and Van
Gieson. The cytological examination was performed on material harvested by
aimed bronchial brushing and/or on stamps from bioptic material, coloured
Giemsa. RESULTS: By histological examination (in the 163 cases) the
diagnostic of broncho-pulmonary cancer was given with the establishing of
the histological type of cancer in 87.12% of the cases, at 17 patients
(10.42%) dysplasia was diagnosed and in 2.45% (4 cases) the examination
was negative. Out of the 163 cytologically examined cases, in 66.25% (108
patients) diagnose of broncho-pulmonary cancer could be given and the
histological type could be established. In 11.66% of the patients the
cytological examination was negative and in 22.08% of the cases the
cytology was strongly suggestive for broncho-pulmonary cancer, but one
could not determine the histological type. According to the current
classification of the broncho-pulmonary cancer by histological
examination, we diagnosed the NSCLC type (non small cell lung carcinoma)
by 123 patients (75.41%) and by cytological examination, by 124 (76.07%);
the type SCLC (small cell lung carcinoma) was identified by histological
examination in 18 cases (11.04%) while the cytological examination allowed
the highlighting of this type of cancer in 5 cases (3.06%). CONCLUSIONS:
Our data indicate the fact that the cytological examination on stamps from
bioptic material or on that obtained by bronchial brushing offers a very
high percentage of positive results, close to the histological one, but
the establishing of the histological type of broncho-pulmonary cancer is
more difficult by cytological examination, due to the heterogeneous
structure of the NSCLC tumors. Despite this, the cytology may be extremely
useful in diagnose of the small, necrotic tumors as well as in that of the
carcinomas with non-small and small cells.
Diagnosis and
typing of lung carcinomas by cytopathologic methods. A review of 108
cases.Acta
Cytol. 1985 May-Jun;29(3):379-84.
A correlative
review was made of the type of cytology specimens (sputum, bronchial
washing and bronchial brushing) together with the corresponding
histopathologic specimens of 108 patients. One hundred patients had
primary pulmonary carcinomas diagnosed histopathologically (84) or
clinically (16); 5 had carcinomas metastatic to the lungs and 3 had
apparently false-positive cytologic results for lung cancer. The
correlative review was used to determine the diagnostic reliability of
pulmonary cytopathologic techniques in the detection and classification of
lung carcinomas (i.e., the sensitivity and accuracy). The overall
sensitivities of sputum, bronchial washing and bronchial brushing cytology
were 60%, 66% and 77%, respectively (p less than 0.05). Bronchial brushing
had a higher sensitivity (80%) for peripheral and metastatic lesions than
did sputum (37%) or bronchial washing (60%). The overall accuracies of
sputum, bronchial washing and bronchial brushing cytology were 79%, 75%
and 76%, respectively, which is not statistically different. Regardless of
the sampling methods, cytologic typing of squamous-cell and small-cell
carcinomas was highly accurate but was less satisfactory for the other
types of lung carcinomas. In the 16 cases in which endoscopic biopsies
were either not attempted or gave negative results, one or more pulmonary
cytologic specimens showed malignant cells. It is concluded that: (1)
pulmonary cytopathologic techniques have excellent sensitivity and
accuracy in the diagnosis of lung carcinomas; (2) they may establish the
diagnosis of pulmonary carcinomas when endoscopic biopsies give negative
results; and (3) they are particularly helpful in cases in which
endoscopic biopsies suffer from a low yield (peripheral lesions) or create
a considerable danger to the patients (iatrogenic hemorrhage).
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