The diagnosis of pulmonary small‐cell anaplastic carcinoma by cytologic means: A 13‐year experience

Abstract

This article reports on a series of 432 patients with positive respiratory (sputum and bronchial) cytology and proven malignant respiratory tract disease as corroborated by detailed verification criteria; 54 of these patients were diagnosed as having small-cell anaplastic carcinoma (SCAC). None of the 31 patients with autopsy-and/or biopsy-proven disease had false-positive results for SCAC. Typing accuracy for SCAC versus non-SCAC was 97.7% in the 263 patients with histologic confirmation of their respiratory tract disease. Twenty-three of the 54 patients (42.6%) were treated for SCAC solely on the basis of positive cytology in the context of compatible clinical data. This finding underscores the great importance of proper specimen preparation, quality control procedures, and diligent clinical follow-up in an era of heightened cost-containment awareness when many patients with pulmonary SCAC will be treated on the basis of positive cytology not immediately confirmed by histologic methods.

The utility of transbronchial (Wang) fine needle aspiration in lung cancer diagnosis

“…Optimal management of a patient with lung carcinoma, including critical therapeutic decisions, requires a higher level of diagnostic accuracy in which the tumour is classified as small cell or non small cell. In published reports, cytology has had a 97–100% accuracy in distinguishing between small cell and non small cell carcinomas, with or without the added information afforded by tissue biopsy 29–31 …”

Lung cancer treated on the basis of cytologic findings: An analysis of 112 patients

“…It is critically important that all cytopathologists recognize the strengths and weaknesses inherent in the techniques they practice. Such an understanding must encom-Diagnostic Cytopathology, Vol6, No 5 pass an appreciation for the role of other diagnostic modalities, such as transthoracic fine-needle aspiration and biopsy obtained at thoracotomy. Thus, it is critically important for cytopathologists and clinicians alike to realize the value of blending diagnostic modalities (including both cytologic and histologic) in order to facilitate optimal patient care.…”