Small-sized adenocarcinoma of the lung - Cytologic characteristics and clinical behavior

BACKGROUND. Although the cytologic characteristics of advanced adenocarcino mas of the lung have been described, the unique cytologic features of early adenocarcinomas have not been established. METHODS. Cytologic specimens from 193 patients with small-sized lung adenoc arcinoma, up to 2 cm in dimension, were reviewed. Cytologic investigations were performed on sputum, bronchial brushings or washings, or fine-needle a spirates obtained from the patients preoperatively. The cytologic character istics of early adenocarcinoma were confirmed with Image Processor for Anal ytical Pathology from Sumitomo Chemical Co., Ltd. RESULTS. Nuclear size, variations in nuclear size, appearance of nucleolus, and nuclear atypia of the adenocarcinoma cells were found to differ betwee n the various histologic subtypes of adenocarcinoma. The nuclei in small bu t advanced adenocarcinoma were generally larger and showed more variation i n size than those in early adenocarcinoma (localized bronchioloalveolar car cinoma). CONCLUSIONS. Surgically curable, early adenocarcinomas of the lung were fou nd to have a unique cytologic appearance, including small nuclear size and slight variation in nuclear size. Using these unique characteristics, they can be distinguished easily from advanced adenocarcinomas. Cancer (Cancer C ytopathol) 2001;93:124-131. (C) 2001 American Cancer Society.