When are electron microscopy, histoculture, and other procedures useful in the clinical evaluation of lung cancer?

The earlier pessimistic outlook on the prognosis of lung cancer has had two particularly adverse effects on progress in pathologic interpretation. There has been little incentive to resolve several basic problems, and little encouragement from clinical investigators to apply electron microscopy, tissue culture, immunopathologic tests, and biochemical assays. However, substantial advances in the clinical detection and management of lung cancer have renewed the clinician's interest in pathologic interpretation. In fact, the pathologist is under increasing pressure to narrow the gap between the diagnosis that routine laboratory examination provides and the more detailed and precise interpretation that can be obtained from a research facility. This report presents recommendations for improving the level of interpretation of the routine diagnostic work-up through modest investments in newer methods, and thorough special tissue processing in anticipation of a need for assistance from the research laboratory.