Diagnostic Accuracy of Exfoliative Pulmonary Cytology

Abstract

he increased incidence of bronchogenic carcinoma has brought with it diagnostic problems, especially in the evaluation of abT normal chest roentgenograms. In primary carcinoma of the lung, bronchial biopsy will reveal the diagnosis in about one-third of cases. Biopsy of scalene lymph nodes in the absence of palpable nodes will demonstrate the presence of metastatic carcinoma in about 10 to 20% of cases. An outcome of the development of exfoliative cytology during the last two decades has been the growing dependence of thoracic surgeons on cytological examination of respiratory secretions to diagnose lung cancer. It is not generally realized, however, that not only can cytological examination of sputum or bronchial aspirate be used to diagnose the presence of bronchogenic carcinoma; it also can be applied to the histological typing of the neoplasms. In our medical center the presence of malignant cells in sputum or bronchial aspirate is regarded as reliable evidence that a malignant neoplasm exists in the respiratory tract. A question has been raised, however, concerning the reliability of cytological examination in the typing of bronchogenic carcinomas. T o answer this question, we have reviewed our experience with 104 cases of bronchogenic carcinoma. In these cases a definite statement as to the type of carcinoma was arrived at by cytological examination, and there was histopathological material to confirm or refute the cytological typing.