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Vol.53 No.3 contents | Japanese/English |
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- Original Article -
Histological Typing Accuracy Rate of Preoperative Bronchoscopic Cytology in Patients with Surgically Resected Lung Carcinoma
Naoki Yanagawa1, Satoshi Shiono2, Masami Abiko2, Mitsunobu Abe1, Kiyoko Watanabe1, Izumi Watanabe1, Miyuki Uematsu1, Shin-ya Ogata1, Toru Sato2, Gen Tamura11Department of Pathology and Laboratory Medicine, 2Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Japan
Objective. We examined the correlation between the preoperative cytological diagnosis and the histopathological diagnosis in patients with lung carcinoma in order to evaluate the diagnostic accuracy of histological typing using bronchoscopic cytology. Study Design. A total of 189 patients with primary lung carcinoma were examined. The patients were initially diagnosed with lung carcinoma using cytology, and the diagnosis was then confirmed using surgically resected specimens. The cytological diagnosis and final histopathological diagnosis were assessed and their correlation was investigated. Results. Histopathologically, 105 cases were diagnosed as adenocarcinoma. Cytologically, 90 cases were diagnosed as adenocarcinoma, seven cases were diagnosed as squamous cell carcinoma and eight cases were diagnosed as non-small cell lung carcinoma, not otherwise specified (NSCLC-NOS). Histopathologically, 74 cases were diagnosed as squamous cell carcinoma. Cytologically, 72 cases were diagnosed as squamous cell carcinoma, one case was diagnosed as adenocarcinoma and one case was diagnosed as NSCLC-NOS. Histopathologically, three cases were diagnosed as large cell carcinoma. Cytologically, two cases were diagnosed as large cell carcinoma and one case was diagnosed as adenocarcinoma. Histopathologically, three cases were diagnosed as small cell lung carcinoma, all of which were also diagnosed as small cell lung carcinoma on a cytological examination. Discordance between the cytological diagnosis and the final histopathological diagnosis was noted in 12 cases, and 10 cases were identified as NSCLC-NOS on a cytological examination. If we consider these 22 cases as being discordant cases, the concordance rate between the cytological diagnosis and the final histopathological diagnosis was 88.4% (167 of 189 examined cases). A solid adenocarcinoma component with mucin production was noted in the discordant and NSCLC-NOS cases on cytological examinations. Conclusions. If a solid appearance is observed on a cytological analysis, histopathological typing should be carefully performed.
key words: Lung carcinoma, Solid adenocarcinoma with mucin, Bronchoscopic cytology, Histopathology, Diagnostic accuracy
Received: April 22, 2013
Accepted: July 3, 2013
JJLC 53 (3): 220-226, 2013
