 |
Vol.47 No.7 contents | Japanese/English |
 | Full Text of PDF (1616K) Article in Japanese |
- Review Article -
Cytology of Adenocarcinoma of Lung
Kenzo Hiroshima11Department of Diagnostic Pathology, Graduate School of Medicine, Chiba University, Japan
The incidence of adenocarcinoma as a percentage of the number of patients diagnosed with all types of lung cancer has increased recently. The cytology of sputum, brushing, or aspiration is the simplest and the most accurate method for the diagnosis of lung carcinoma along with histologic biopsy. The exfoliated cancer cells in sputum are large, usually round or polygonal, occasionally columnar, and are found in clusters or singly. The cell clusters have a three-dimensional papillary or spherical configuration. Cytoplasm of the cancer cells is pale or finely vacuolated. The large mucin vacuoles displace the nucleus to one side. The nuclei of adenocarcinoma are large with finely granular chromatin with prominent nucleoli. In bronchial brushing specimen, the tumor cells are more abundant than in sputum. Cancer cells appear in papillary clusters, or in sheets of large round or polygonal cells. The nuclei may be clear and vesicular and have visible and prominent nucleoli. Atypical type II pneumocytes are potentially important source of false-positive diagnosis of adenocarcinoma. The reactive pneumocytes are large cells with prominent nucleoli occurring singly and in small clusters. Differentiation of primary from metastatic adenocarcinoma of similar histologic type is clinically important but may prove impossible on cytologic criteria alone. There are cytologic patterns in which a preference for the primary site of origin of a metastatic carcinoma may be expressed.
key words: Lung carcinoma, Adenocarcinoma, Cytology, Atypical adenomatous hyperplasia, Type II pneumocyte
JJLC 47 (7): 837-847, 2007
