TUMOURS of the lower respiratory tract have generally been regarded as bronchial tumours. However, some authors (Garland, Beier, Coulson, Heald and Stein, 1962;Lisa, Trinidad and Rosenblatt, 1965) have pointed out recently that many pulmonary tumours have a peripheral origin. A similar conclusion was reached by Mottura and Campobasso (1966) who described the histological features of 557 tumours of the lung, studied on postmortem specimens and surgical resections. They concluded that these tumours could be classified histologically under four headings: anaplastic small cell carcinoma; squamous cell carcinoma; anaplastic large cell carcinoma and adenocarcinoma. This classification is not new and is very similar to that used by other workers (Fischer, 1949;McDonald, McBurney, Carlisle and Patton, 1951;Walter and Pryce, 1955; Whitwell, 1961;Delarue, Abelanet and Paillas, 1964), but the recent work has provided a new histogenetic basis for the classification, which suggests that among the tumours of the lower respiratory tract, a distinction should be made between the true bronchogenic carcinomas, which include anaplastic small cell carcinoma and squamous cell carcinoma, and the bronchiolo-alveolar carcinomas which include anaplastic large cell carcinoma and adenocarcinoma, the latter being tumours of the lung parenchyma.On the other hand, bronchial epithelium is, in the main, a lining epithelium and its histological and ultrastructural appearances are different from bronchiolar and alveolar epithelium (Krahl, 1963;Collet, 1965). The latter are directly concerned with respiratory function and are responsible for the growth and regeneration of pulmonary tissue, both in foetal and post-natal life (Willson, 1928;Amprino, 1937;Dunnill, 1962). Consequently, it seems logical to assume that if two kinds of epithelium exist, two kinds of tumour also exist, each related to the respective type of epithelium of origin.The purpose of this present paper is to illustrate the significance of the relationship between the location of the tumour and its histological type, and to describe and to discuss some histological aspects of peripheral lung tumours. This has provided more evidence to show that tumours of the lower respiratory tract may well be of two histogenetic patterns.
MATERIALS AND METHODSFive hundred and thirty-one tumours were obtained by surgical resection at the Thoracic Surgery Centre of the University of Turin. The tumours were sub-divided into hilar-parahilar and peripheral tumours, according to whether or not they were in obvious connection with the bronchial tree. To establish whether or not this connection existed, all the bronchial branches were cut and opened 57