1984 Volume 23 Issue 1 Pages 57-64
We report here cytological approach to metastasizing lung cancers. These tumors tend to manifest themselves irrespective of the bronchial epithelium or in the peripheral lung field, in spite of a higher frequency of metastasis to the lung as compared to other organs. Therefore, it is rather difficult to obtain bronchoscopically cells or tissues from metastatic focus, to diagnose these materials to be malignant, and to ascertain the primary sites. Our institutions have performed bronchoscopy on more than 150 cases with the pulmonary tumors for one-year period. During two years between from 1981 to 1982, we experienced four cases with metastasizing tumors which were visualized bronchoscopically because of their protrusion into the bronchial lumen ; the mode of these metastases to the lung is rather unusual. We have analized these four cases based on the findings obtained through x rays, bronchoscopy, cytology and pathology, and compared the cytopathologic findings with those of the primary tumors.
These cases are: Case 1: a 45-year-old female with breast cancer. X-ray film showed the right middle pulmonary atelectasis due to obstructed entrance of the bronchus to the middle lobe. Imprints of biopsied materials consisted of cell clusters simulating small cell carcinoma. Case 2: a 48-year-old male with colon cancer. X-ray film showed a tumor shadow in the right lower lung field, and bronchoscopy revealed an irregular-surfaced, elevated lesion at the right lower lobe bronchus. Brushing materials consisted of cell clusters with highcolumnar epithelium. Case 3: a 68-year-old female with thyroid cancer. X-ray film showed a spherical tumor shadow in the left middle lung field, and bronchoscopy revealed a hemi-shperical elevation at the entrance to the left B4a. Imprints consisted of cell clusters with homogeneous and round nucleus. Case 4: a 77-year-old male with renal cancer. X-ray film showed a tumor shadow in the right lower lung field, and bronchoscopy revealed a cauliflower-like tumor formation at the entrance to right Bo. Imprints consisted of flattened cell clusters with clear, ample cytoplasm.
