BRONCHIAL ASPIRATE IN THE TYPING OF LUNG-TUMORS - CYTOLOGIC AND HISTOLOGIC CORRELATIONS IN 150 CASES

We analysed 150 cases of primary lung cancers investigated by bronchial aspirate and biopsy methods with clinical, radiologic and bronchoscopic findings. Among the 150 cases studied, three were characterized by mixed tumor cell components, thus allowing 153 cyto-histological comparisons. The cytologic and histopathologic typing agreed strictly in 102 cases of 153 (66.7%) and was considered as correct in 40 cases (26.1%). Only cases with divergent evaluation between small-cell carcinoma and non small-cell carcinoma were considered as discordant: such misclassification occurred in 11 specimens (7.2%), including two cases with mixed patterns. The cytologic typing was in agreement with the final diagnosis in all epidermoid carcinomas, adenocarcinomas, large-cell carcinomas and poorly differentiated carcinomas. In small-cell carcinomas, cytology was in agreement with histopathology in 20 of 26 cases (77%), and could only indicate undifferentiated features in four cases (15.4%). The analysis of bronchial aspirate specimens gave reliable typing in 92% of cases, and indicated a better tumor cell differentiation than histopathology in 6.5% of cases. The results obtained show that aggressive treatments can be reliably proposed on the basis of cytologic findings, even without tissue corroboration. This proposal is particularly helpful in cases where biopsy cannot be performed (peripheral lesions) or creates a danger to the patient (iatrogenic hemorrhage).