Triple fine-needle biopsy of Kulchitsky cell carcinomas I, II (bronchial adenomas)

All bronchial adenomas (BA) or Kulchitsky cell tumours I, II, are classified by WHO as low-grade malignomas. In some cases with an established benign clinical course and stability over a period of years, the pre-operative diagnosis of a typical carcinoid (KCCI) may justify a wait-and-see approach. If surgery is indicated, local resection is feasible in place of lobectomy or pneumonectomy. In a consecutive series of thirty-two patients KCCI, II or BA were diagnosed pre-operatively by fine-needle biopsies (FNB). Samples from three different sites were obtained, permitting appropriate diagnostic management and treatment. The thirty-two BA comprised 22 typical carcinoids, five atypical carcinoids, and five cylindromas. Twenty-eight patients presented with a "benign" cytohistological and/or clinical appearance. In four out of thirty-two patients, signs of malignancy with or without metastases were present. No major complication occurred. In a five-year follow-up, 25 out of 32 patients remained alive. One patient was alive but had metastases. Three out of 32 patients with cytohistologic malignant features had died of their disease. In four out of 32 patients the cause of death was not attributed to neoplastic disease.