210

accurate but was less satisfactory for the other types of lung carcinomas. In the

16 cases in which endoscopic biopsies were either not attempted or gave negative re- sults, one or more pulmonary cytologic specimens showed malignant cells. It is concluded that: (I) pulmonary cytopatho- logic techniques have excellent sensitivity and accuracy in the diagnosis of lung car- cinomas; (2) they may establish the diag- nosis of pulmonary carcinomas when endo- scopic biopsies give negative results; and (3) they are particularly helpful in cases which endoscopic biopsies suffer from a low yield (peripheral lesions) or create a considerable danger to the patients

(iatrogenic hemorrhage).

The Application of Visual Cell Profiles in the Study of Premalignant Atypias in

Sput~n. Swank, PoR., Greenberg, S.D., Montalvo, J. et al. Department of Pathology, Baylor College of Medicine, Houston, TX 77030, U.S.A. Acta Cytol. 29: 373-378, 1985.

Because the diagnosis of squamous-cell carcinoma of the lung by routine cytolo- gic screening of sputum is often incon- clusive, our laboratory is studying the use of cytomorphologic profiles as a re- liable diagnostic aid. This study reports the analysis of the profiles of 75 subjects, both cigarette-smoking volunteers and hospitalized patients suspect for lung cancer. Twenty-five of the subjects had been classified as having squamous meta- plasia, 25 as having atypias and 25 as having squamous-cell carcinoma. Four sli- des were made for each subject, with i00 random fields viewed on each slide. The frequency of free alveolar macrophages, metaplastic squamous cells, epithelial atypical cells and malignant squamous cell were noted for each field. The re- sults indicated that although there were large differences between individual pro- files within each diagnostic category, there were significant differences between the average profiles for each diagnostic category. Furthermore, although there were differences in cell frequencies from slide to slide and within slides, the differences were constant across diagno- stic categories. The results are suppor- tive of the progressive-atypia hypothe- sis for squamous-cell carcinoma of the lung and provide a baseline for comparison with subsequent individual profilesu

Pulmonary Cytologic Examination in the Identification of the Second Primary Car- cinoma of the LLmgo Broghamer, W.L., Richards, M.E., Bisco- pink, R.J., Faurest, S.H~ Veterans Ad- ministration Medical Center, Louisville,

KY 40202, UoS~A. Cancer 56: 2664-2668, 1985.

Multiple primary carcinomas of the lung were histologically confirmed in 23 male patients Five were synchronous neoplasms. Seventeen of the se- cond pulmonary cancers originated in the contra- lateral lung. The major cell type was epidermoid (17/23), and in ii patients the tumor was similar in histologic features to the first lesion° Exa- mination of pulmonary secretions as a diagnostic aid in the identification of the second malignant neoplasm was employed for 73.9% (17/23) of the patients° With a single exception, these were ob- tained at the second diagnostic hospitalization rather than as an outpatient monitoring procedure. Or41y nine patients had a series of cytologic pre- parations consisting of three consecutive early morning sputa, bronchial washings/brushings, and a postbronchoscopy sputum. A cytodiagnosis of cancer was established in 82.4% (14/17) of the ca- ses and preceded histologic verification in ten. Radiologic evidence of a second primary was noted in only 56.5% (13/23) of the patients. Pulmonary cytologic examination as a monitoring procedure was not employed in the outpatient follow-up for 64 patients surviving pulmonary cancer for 18 months or longer. Posttherapeutic studies were ob- tained on 39.1% (25/64) of the hospitalized pa- tientSo Thirty-two percent (8/25) were collected concurrently, with tissue biopsies for the con- formation of recurrence or metastasis. Patients with primary pulmonary cancers resected for cure should be monitored on a regular basis to include the cytologic examination of three consecutive early monitoring sputa and a chest radiograph.

H~nan Lung Tt~nours: A Correlation of Antigenic Profile with Histological Type° Gatter, K.C., Dunnill, M.S., Pulford, K.A.F. et al. Nuffield Department of Pathology, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom. Histopathology 9: 805-823, 1985.

Fifty-four human lung tumours have been immuno- stained with a large panel of monoclonal antibodi- es including reagents against cytokeratins, preke- ratins, epithelial membrane antigen (EMA), carcino- embryonic antigen (CEA) and neural antigens. These results have been compared with the histological types of tumour using the current WHO classifica- tion scheme. The most striking finding of this stu- dy was the considerable overlap of antigenic pro- file between different histological types of tu- mour. This suggests that there may be a greater underlying similarity between different histologi- cal categories of lung tumour than has hitherto been assu~led. Secondly it was evident that immunostai- ning highlighted areas of different morphology within many tumours emphasizing the heterogeneous differentiation patterns seen in lung cancers. The present study supports the viewpoint that lung tumours arise from a common stem cell and that these neoplasms represent a single tumour with a tendency to differentiate along one or more path- ways.

Relation Between 201-TI to 67-Ga Uptake Ratio