Percutaneous fine-needle cytology for lung cancer diagnosis

The authors have performed 1,758 needle cytology procedures since 1966 in cases suspected of lung cancer. The results of percutaneous aspiration fine-needle cytology in 232 patients with lung cancer lesions between January 1973 and August 1984 are discussed. Of the 232 cases, lung cancer was diagnosed in 211 cases by this needle cytology technique. This procedure was performed only in peripheral tumors. Positive diagnosis was obtained in 32 out of 36 cases (88.89%) of tumors less than 2 cm in diameter and 179 out 196 cases (91.33%) 2 cm or more in diameter. Twenty-one cases showed false-negative results for malignant diagnosis. There were two false-positive cases, which were resected on a diagnosis of lung cancer that was later revised to inflammatory lesions. The specimens were apparently obtained from areas of severely atypical squamous metaplastic cells. Among 1,758 procedures, 209 complications were observed. In conclusion, for the diagnosis of peripheral lung cancer, percutaneous needle cytology yields a high degree of diagnostic accuracy and is safe, rapid, and economical.