1982 Volume 21 Issue 4 Pages 693-701
There have been some instances of dying from adenocarcinoma which arise in the peripheral bronchus of the lung and tend to spread by way of vascular system early in the postoperative course of the disease unexpectedly.
Accordingly the cytomorphology of those adenocarcinoma cells in correlation with their histological differentiation and clinical stage were reviewed in order to determine whether it may offer valuable information for improving the result in the treatment of those neoplasms.
Material and Methods: The specimen examined in this study consisted of imprint touch smear and histological sections from a total of 53 cases in which surgical resections had been performed.
All of the cytological slides were stained with Papanicolaou, PAS and alcian-blue stain respectively.
As far as the histological differentiation is concerned, all of the cases were classified as well differentiated type in 29, moderately differentiated type in 9 and poorly differentiated in 6, including 9 cases composed of tall columnar epithelial cells as alveolar cell type, separately.
With assignment of the clinical stage, they included 24 cases in stage I, 7 cases in stage II, 17 cases in stage III and 5 cases in stage IV.
Results: Based on the observation made in this study, there was a striking correlation between the histological differentiation and clinical stage.
The degree of the histological differentiation increased with the number of cases belonged to stage I and II.
Subsequently, the incidence of the alveolar cell type was approximately, in accordance with that of well differentiated type.
The pleomorphism, hyperchromasia, folding effects of nuclei among cytologic findings observed in the slides stained with Papanicolaou's method related to both of the histological differentiation and the clinical stage.
There was, however, scanty of impressive cytologic findings considered useful for comparison with the histological differentiation and the clinical stage in all cases of alveolar cell type.
In view of objective cells stained with PAS were classified them into diffuse, granular and block type, if they were positive.
A total of 100 adenocarcinoma cells were observed in each of them and the poorly differentiated type yielded the lowest positive rate, compared with other types among which the positive rate did not significantly differ.
No difference was, however, noted in between the positive rate of cells stained with PAS and the clinical stage.
By the classification mentioned above, the diffuse type found to be rare in the poorly differentiated types was noted in a large percentage of cases belowing to alveolar cell type.
Furthermore, granular type was found to be inconscpicuous in poorly differentiated types, whereas the block type was present remarkably at a high rate in the alveolar cell types.
Those three types had no relationship to the clinical stage.
The incidence of the cells which had positive with alcian-blue stain and belonged to IX type (cell surface type) by Yatani's classification was significantly high in the alveolar cell type.
From the view of the clinical staging, the positive rate was relatively low in the cases of clinical stage III and IV.
