Value of sputum cytology in the differential diagnosis of alveolar cell carcinoma from bronchogenic adenocarcinoma.

A total of 90 cases in which a cytologic diagnosis of pulmonary adenocarcinoma has been previously made by consecutive sputum cytology were reviewed in order to estimate the possibility of a correct differential diagnosis of alveolar cell carcinoma (bronchioloalveolar) from bronchogenic adenocarcinoma. The diagnosis by sputum cytology in all cases was correlated with data from a subsequent biopsy, operation or autopsy. Using certain specific differential diagnostic cytologic parameters, striking differences were noted in the exfoliated cells in sputum samples; these related to cell size, clustering effects, pleomorphism, mucin production, cytoplasm, nuclei and nucleoli. Based on the observations made in this study, it is suggested that sputum cytology is not only a valuable method of detecting malignant cells but can also be quite useful to correctly type all cases of alveolar cell carcinoma and 93.75% cases of bronchogenic adenocarcinoma.