The diagnosis of pulmonary small-cell anaplastic carcinoma by cytologic means: a 13-year experience

This article reports on a series of 432 patients with positive respiratory (sputum and bronchial) cytology and proven malignant respiratory tract disease as corroborated by detailed verification criteria; 54 of these patients were diagnosed as having small-cell anaplastic carcinoma (SCAC). None of the 31 patients with autopsy-and/or biopsy-proven disease had false-positive results for SCAC. Typing accuracy for SCAC versus non-SCAC was 97.7% in the 263 patients with histologic confirmation of their respiratory tract disease. Twenty-three of the 54 patients (42.6%) were treated for SCAC solely on the basis of positive cytology in the context of compatible clinical data. This finding underscores the great importance of proper specimen preparation, quality control procedures, and diligent clinical follow-up in an era of heightened cost-containment awareness when many patients with pulmonary SCAC will be treated on the basis of positive cytology not immediately confirmed by histologic methods.