[Do pathologic-anatomic data influence the staging of non-small cell bronchial cancer?]

The histopathology criteria which could be taken into account in devising the best strategy in tumor extension search in non small cell lung carcinoma (NSCLC), were examined. First, the differential diagnosis between primary and metastatic carcinoma is impossible on histological basis in squamous carcinomas, and in mucinous adenocarcinoma which share several features with tumors from digestive tract including mucus secretion, morphological pattern and ultrastructural signs. The recognition of cells which are unique in the lung (Clara cells, pneumonocytes II) guarantees the pulmonary origin of a non mucinous adenocarcinoma. In other cases such as large cell carcinomas, the diagnosis of metastasis can be achieved in some instances in using a large panel of immunohistochemical markers. Secondly, the expression of neuroendocrine markers in NSCLC could lead to an extension search procedure identical to that of SCLC, if it can be confirmed that they share their poor prognosis and chemosensibility. Finally, there is no statistical evidence of a difference in the extrathoracic extension between well and poorly differentiated forms of squamous carcinoma and adenocarcinoma. Only one exception should be made for the recently described basaloid carcinoma of the lung which extension and prognosis are more severe than in other NSCLC.