Cytologic Studies of So-called Bronchiolo-Alveolar Cell Carcinoma

Abstract

Eight cases of bronchioloalveolar cell carcinoma were reviewed cytologically, and differential diagnosis conducted accordingly.There are two problems underlying differential diagnosis of bronchioloalveolar cell carcinoma. First, it is difficult to differentiate tumor cells from benign hyperplastic cells, especially in sputum cytology, owing to both the uniformity of tumor cells and the lesser degree of cellular atypism. Second, even if such cells are diagnosed as malignant, differentiation of these cells from the cells derived from other types of adenocarcinoma is problematic.Consequently, in an attempt to resolve these difficulties, the authors marked the shapes of tumor cell clusters by the bronchial brushing method. The shapes characteristic of cell clusters are presented below, and serve as a useful guide in cytological diagnosis of bronchioloalveolar cell carcinoma.1. Single-layer cluster of cells along a one-dimensional plane, in which cell circumferences are smooth and/or sometimes dented.2. Solid multi-layered cell cluster exhibiting distinct cell boundaries and abundant cytoplasma, conforming to a tortoise shell or honeycomb pattern.3. Solid multi-layered cell cluster surrounded by amorphous mucin in which the cluster appears floating.4. Solid multi-layered cell cluster conforming to a pattern similar to a bunch of grapes.