Effect of methods of sample taking on the cytologic diagnosis of lung tumors

By the evaluation of unselected cytologic specimens taken by different methods, the possible effect of sampling on the cytologic diagnosis was analyzed. A statistically significant tendency was established for certain tumors to be better diagnosed by certain methods of sampling. In order of the increasing radicality of the method, the following significant coincidences were found and discussed: Sputum for the diagnosis of bronchialalveolar cell carcinoma and epidermoid carcinoma (cornified cells); Bronchial washing for oatcell (undifferentiated) carcinoma and epidermoid carcinoma (moderately cornified cells); Bronchial brushing for epidermoid carcinoma (not cornified cells) and large cell (undifferentiated) carcinoma; Transthoracal needle aspiration for polymorphic carcinoma and metastasis; and Pleural effusion for the diagnosis of metastasis, bronchogenic adenocarcinoma and mesothelioma. If the clinical features indicate a certain tumor type, the data give evidence that it is advantageous to adjust the method of sample taking to the expected tumor type as far as possible. In the case of necessary re-examinations, transthoracic needle aspiration and bronchial brushing should especially be used, in addition to the self-evident examination of material produced spontaneously, i.e., sputum and pleural effusion, because of the relatively high expected value of these methods for positive diagnoses in re-examinations.