[Contributions to the morphological basis of the cytology of the respiratory tract (author's transl)].
It is reported on 275 cases treated for bronchial carcinoma at the Surgical Departement of Düsseldorf University between 1970 and 1974. In all cases cytological as well as histological methods were used for diagnosis. These cases are complemented by 60 cases selected under cytological aspects from other sources. Localization by X-ray proved a central tumor in 11% and tumors in the different lobes in 89% of the cases. Tumors were more frequent in the upper lobes (54%) than in the lower lobes (30%), and more frequent in the right lung (58%) than in the left (42%). Cytological smears were positive or suspicious in 77% of the central carcinoma and in 60 and 56% in cases of roentgenologically peripheral localization. There is no difference found between tumors in the upper and lower lobes. Bronchial secretion renders less positive results for all histological types. This indicates a small area of origin for the cells investigated by this method. Metaplastic cell changes were observed in one third of all cases involving all histological types equally. Operation was possible in only 30% of the cytologically diagnosed cases in comparison to 52% of all cases. The 60 selected cases were composed of 48 primary and twelve secondary tumors. Probatory excision had been performed in 50%, 8% remaining negative even after repetition. 33% could only be verified by autopsy corresponding to 29% with sputa, bronchial aspirate and pleural effusion positive at the same time and therefore regarded as late stages. Negative results can be caused by fibrosis as well as obstruction, fibrosis not being a regular result of treatment with X rays. Differentiation of tumor types is possible in cytological smears. Sometimes differences in the same tumor are evident and occasionally the tumor type can be more distinct in the cytological preparations. Metastatic tumor cells are open to false classification. Tumor and tuberculosis were found in four of sixty cases. One false positive result was caused by cells ressembling cases of experimentally induced bronchiolization of alveoli by different noxa.
D001984:Bronchial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003581:Cytodiagnosis; D006651:Histocytochemistry; D006801:Humans
Beiträge zu den morphologischen Grundlagen der Zytologie des Respirationstraktes.