At the 92 nd Annual Meeting of the Texas Society of Pathologists, William Travis, MD, of Memorial SloanKettering Cancer Center, New York, New York, received the esteemed Stembridge Award in recognition of his many years of leadership in the field of pulmonary pathology. Dr. Travis delivered 2 superb lectures on the implications of the new classification of adenocarcinoma jointly proposed by the International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society (the Stembridge Lecture at the annual meeting and a companion grand rounds at MD Anderson Cancer Center). Dr. Travis and his colleagues have contributed 2 compelling articles to the Archives of Pathology & Laboratory Medicine based on the same content as those lectures: (1) Diagnosis of Lung Cancer in Small Biopsies and Cytology: Implications of the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification and (2) Diagnosis of Lung Adenocarcinoma in Resected Specimens: Implications of the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification. Along with Elisabeth Brambilla, MD, of Grenoble, France, Dr. Travis was the leader of the World Health Organization lung cancer classification in 1999 and 2004 and is now leading a new revision that will likely incorporate the proposed classification of adenocarcinoma. This proposal is a component of the revolution in lung cancer that has occurred during the past several years. For the first time, a classification of lung cancer takes into account that 70% of all cases present in an advanced stage and, therefore, the only tissue samples obtained of the tumor are small biopsies and/or cytology specimens. Currently, cell type (adenocarcinoma versus squamous cell carcinoma) is a basis for triaging lung cancer specimens for predictive biomarker testing, but cell subtypes are not considered, although there are some associations between subtypes and likelihood of specific biomarkers being present. Therefore, differentiation of adenocarcinoma from squamous cell carcinoma is a key aspect of the new proposal. No doubt experts will debate the merits of specific details in the proposal, but one concern at least may be lessened by recent technologic advances and we would like to briefly expound on that here. As noted by Dr. Travis and his colleagues, the very limited amount of tissue obtained for most lung cancers must be carefully rationed for use in traditional microscopic examination, immunohistochemistry studies to confirm cell type and/or primary site, and a growing number of predictive biomarkers that are needed to determine the optimal treatment protocol. The conservation of adequate tissue for performing each of these numerous tests potentially becomes a major challenge, particularly if separate molecular assays are performed for each biomarker as has traditionally been done. Several recent advances help address the challenge of conserving tissue from small biopsies and cytology specimens. For determining cell type, antibody cocktails such as desmoglein 3 þ cytokeratin 5/napsin A or p40/thyroid transcription factor 1 (Biocare Medical, Concord, California) allow multiple immunostains for cell type differentiation on a single slide. Molecular classification of cancers of unknown origin, for example CancerTYPE ID from bioTheranostics, San Diego, California, can be done with a few hundred cells as opposed to multiple tissue sections for several separate immunostains. Recently introduced ‘‘next generation’’ sequencing technologies help address the challenge of conserving tissue by rapidly and inexpensively generating highly multiplexed tumor genotypes with a single reaction that may require no more than 10 to 250 ng of input genomic DNA from a tumor sample. Examples include the 454 GS Junior (454 Life Sciences, Roche, Branford, Connecticut), Ion Torrent Personal Genome Machine (Ion Torrent Systems, Life Technologies, San Francisco, California), and MiSeq Personal Sequencer (Illumina Inc, San Diego, California). The MassARRAY Analyzer (Sequenom Inc, San Diego, California) uses mass spectrometry of amplified gene fragments to determine their genotype and, using novel strategies, simultaneously evaluate gene mutations and gene rearrangements in a single run. Therefore, utilizing From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas; and the Department of Pathology and Laboratory Medicine at Weill Medical College of Cornell University, New York, New York. doi: 10.5858/arpa.2013-0950-ED. The authors have no relevant financial interest in the products or companies described in this article. Corresponding author: Philip T. Cagle, MD, Department of Pathology and Genomic Medicine, The Methodist Hospital, 6565 Fannin Street, Main Building, Room 227, Houston, TX 77030 (e-mail: pcagle@tmhs.org).