Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1982 Apr;35(4):414–419. doi: 10.1136/jcp.35.4.414

Accuracy of morphological diagnosis of lung cancer in a department of respiratory medicine.

M D Clee, H L Duguid, D J Sinclair
PMCID: PMC497672  PMID: 7076869

Abstract

In view of the importance of determination of cell type in patients with bronchial carcinoma who are to be given chemotherapy a series of 140 histologically proved cases was analysed to assess the accuracy of pretreatment diagnosis by cytology and bronchial biopsy. Final histological diagnosis was made after thoracotomy (131 cases) or necropsy (9 cases). Before treatment, malignancy was diagnosed in 71% of cases with 91% accuracy in cell typing. Diagnostic yield was greatest in squamous carcinoma (81%) and least with adenocarcinoma (50%). Large-celled and small-celled anaplastic carcinomas gave yields of 61% and 68% respectively. Accuracy of cell typing was high (90-97%) except for large-celled anaplastic carcinoma (71%). All diagnostic methods were not employed in every case. In patients supplying samples the diagnosis was made by sputum cytology in 57%, by rigid bronchoscopy cytology in 57%, by fibreoptic bronchoscopy cytology in 71% and biopsy in 53%. Causes of diagnostic failures and possible means of increasing accuracy of pretreatment diagnosis were discussed.

Full text

PDF
419

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bedrossian C. W., Rybka D. L. Bronchial brushing during fiberoptic bronchoscopy for the cytodiagnosis of lung cancer: comparison with sputum and bronchial washings. Acta Cytol. 1976 Sep-Oct;20(5):446–453. [PubMed] [Google Scholar]
  2. Bibbo M., Fennessy J. J., Lu C. T., Straus F. H., Variakojis D., Wied G. L. Bronchial brushing technique for the cytologic diagnosis of peripheral lung lesions. A review of 693 cases. Acta Cytol. 1973 May-Jun;17(3):245–251. [PubMed] [Google Scholar]
  3. Chopra S. K., Genovesi M. G., Simmons D. H., Gothe B. Fiberoptic bronchoscopy in the diagnosis of lung cancer comparison of pre-and post-bronchoscopy sputa, washings, bruchings and biopsies. Acta Cytol. 1977 Jul-Aug;21(4):524–527. [PubMed] [Google Scholar]
  4. Dahlgren S. E., Lind B. Comparison between diagnostic results obtained by transthoracic needle biopsy and by sputum cytology. Acta Cytol. 1972 Jan-Feb;16(1):53–58. [PubMed] [Google Scholar]
  5. Erozan Y. S., Frost J. K. Cytopathologic diagnosis of cancer in pulmonary material: a critical histopathologic correlation. Acta Cytol. 1970 Nov-Dec;14(9):560–565. [PubMed] [Google Scholar]
  6. Hanson R. R., Zavala D. C., Rhodes M. L., Keim L. W., Smith J. D. Transbronchial biopsy via flexible fiberoptic bronchoscope; results in 164 patients. Am Rev Respir Dis. 1976 Jul;114(1):67–72. doi: 10.1164/arrd.1976.114.1.67. [DOI] [PubMed] [Google Scholar]
  7. Johnston W. W., Frable W. J. The cytopathology of the respiratory tract. A review. Am J Pathol. 1976 Aug;84(2):372–424. [PMC free article] [PubMed] [Google Scholar]
  8. KOSS L. G., MELAMED M. R., GOODNER J. T. PULMONARY CYTOLOGY--A BRIEF SURVEY OF DIAGNOSTIC RESULTS FROM JULY 1ST 1952 UNTIL DECEMBER 31ST, 1960. Acta Cytol. 1964 Mar-Apr;8:104–113. [PubMed] [Google Scholar]
  9. Kvale P. A., Bode F. R., Kini S. Diagnostic accuracy in lung cancer; comparison of techniques used in association with flexible fiberoptic bronchoscopy. Chest. 1976 Jun;69(6):752–757. doi: 10.1378/chest.69.6.752. [DOI] [PubMed] [Google Scholar]
  10. Macdonald J. B. Fibreoptic bronchoscopy today: a review of 255 cases. Br Med J. 1975 Sep 27;3(5986):753–755. doi: 10.1136/bmj.3.5986.753. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Mennemeyer R., Hammar S. P., Bauermeister D. E., Wheelis R. F., Jones H. W., Bartha M. Cytologic, histologic and electron microscopic correlations in poorly differentiated primary lung carcinoma. A study of 43 cases. Acta Cytol. 1979 Jul-Aug;23(4):297–302. [PubMed] [Google Scholar]
  12. Oswald N. C., Hinson K. F., Canti G., Miller A. B. The diagnosis of primary lung cancer with special reference to sputum cytology. Thorax. 1971 Nov;26(6):623–627. doi: 10.1136/thx.26.6.623. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Richardson R. H., Zavala D. C., Mukerjee P. K., Bedell G. N. The use of fiberoptic bronchoscopy and brush biopsy in the diagnosis of suspected pulmonary malignancy. Am Rev Respir Dis. 1974 Jan;109(1):63–66. doi: 10.1164/arrd.1974.109.1.63. [DOI] [PubMed] [Google Scholar]
  14. Roger V., Nasiell M., Linden M., Enstad I. Cytologic differential diagnosis of bronchiolo-alveolar carcinoma and bronchogenic adenocarcinoma. Acta Cytol. 1976 Jul-Aug;20(4):303–307. [PubMed] [Google Scholar]
  15. Sackner M. A. Bronchofiberscopy. Am Rev Respir Dis. 1975 Jan;111(1):62–88. doi: 10.1164/arrd.1975.111.1.62. [DOI] [PubMed] [Google Scholar]
  16. Solomon D. A., Solliday N. H., Gracey D. R. Cytology in fiberoptic bronchoscopy. Comparison of bronchial brushing, washing and post-bronchoscopy sputum. Chest. 1974 Jun;65(6):616–619. doi: 10.1378/chest.65.6.616. [DOI] [PubMed] [Google Scholar]
  17. Spriggs A. I., Boddington M. M. Oat-cell bronchial carcinoma. Identification of cells in pleural fluid. Acta Cytol. 1976 Nov-Dec;20(6):525–529. [PubMed] [Google Scholar]
  18. Webb J., Clarke S. W. A comparison of biopsy results using rigid and fibreoptic bronchoscopes. Br J Dis Chest. 1980 Jan;74(1):81–83. [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES