Journal Mobile

WAH Wallace
Journal Issue: 
Volume 38: Issue 4: 2008




The examination of histological and cytological specimens plays a pivotal role in the diagnosis and staging of lung cancer. This review aims to describe why the correct choice of specimen type may be important in optimising patient management. Tissue  biopsies  obtained  for  diagnosis  provide  specimens  that  are  the  most  highly sensitive  for  the  diagnosis  of  malignancy  and  cell  typing.  In  addition,  they  provide sufficient  material  for  further  detailed  studies,  either  at  the  time  of  diagnosis  or subsequently during the patient’s management. Cytology specimens, in contrast, have generally lower sensitivities, are recognised to be prone to false positive errors and in  many  instances  provide  very  limited  material  for  detailed  immunohistochemical studies. Cytology specimens will, however, have an increasingly important role in lung cancer staging with the development of minimally invasive endoscopic techniques for sampling mediastinal lymph nodes. Lymph node aspiration, either via the oesophagus or the bronchus, provides a highly sensitive method for the detection of metastatic carcinoma.  Furthermore,  this  allows  access  to  nodal  groups  not  assessable  by mediastinoscopy. In future, tissue biopsy for histological assessment should be seen as the ‘gold standard’ for primary diagnosis in lung cancer patients.