The Current Role of Exfoliative Cytopathology in the Routine Diagnosis of Bronchogenic Carcinoma

A Five-Year Study of 152 Consecutive, Unselected Cases

¹ The Departments of Pathology, Veterans Administration Hospital and University of Michigan.

1. In 152 consecutive unselected patients with histologically proved carcinoma of the lung, including six with unsuspected neoplasms at necropsies, a microscopic diagnosis was established by exfoliative cytopathology in 100 cases. Twenty-six of the 152 patients were not examined by the smear technique and 26 had negative smears.

2. A positive cytologic diagnosis was made more frequently (65.8 per cent) than a prethoracotomy histologic diagnosis (52.0 per cent) using all types of standard biopsy methods.

3. In 25 per cent of the patients, exfoliative cytopathology provided the only microscopic evidence of carcinoma prior to thoracotomy or necropsy.

4. Exfoliative cytodiagnosis increased the prethoracotomy microscopic diagnosis of carcinoma of the lung from 36 per cent to 72 per cent in 50 patients whose carcinomas were resected.

5. That cytologic diagnosis of carcinoma of lower lobes was 16.8 per cent greater than that of upper lobes. The frequency of malignant cells in sputum or bronchial aspirates varied inversely with the distance of the neoplasm from the carina, except for peripheral tumors over five centimeters in size which were detected as frequently as were those in the hilar areas.