title: Adenosquamous carcinoma of the lung diagnosed by cytology?: a diagnostic dilemma.
abstract: Adenosquamous cell carcinomas of the lung are rare tumours and are associated with a poor prognosis compared to other non-small cell carcinomas. We report a case of a solitary lung carcinoma evaluated by bronchial brush and lavage cytology, bronchial biopsy and pleural fluid cytology. Cytological assessment of the pleural fluid demonstrated non-small cell carcinoma and immunohistochemical staining confirmed a metastatic lung adenocarcinoma. The bronchial brush and lavage specimens, however, demonstrated the cytomorphological features of squamous cell carcinoma, which was confirmed by the bronchial biopsy. The finding of a mixed squamous and glandular component predicts a poor prognosis for this patient. The identification of a squamous component with the non-small cell carcinoma is important as this excludes the patient from anti-VEGF monoclonal antibody treatment due to the increased risk of haemorrhage.
authors.affiliation: Cellular Pathology, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester, United Kingdom. davidshelton@doctors.org.uk
authors.forename: David A
authors.initials: DA
authors.lastname: Shelton
authors.forename: Durgesh N
authors.initials: DN
authors.lastname: Rana
authors.forename: Miles
authors.initials: M
authors.lastname: Holbrook
authors.forename: Paul
authors.initials: P
authors.lastname: Taylor
authors.forename: Simon
authors.initials: S
authors.lastname: Bailey
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000175:diagnosis; D000077192:Adenocarcinoma of Lung; D000368:Aged; D014408:Biomarkers, Tumor / Q000737:chemistry; D001706:Biopsy / Q000379:methods; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D018196:Carcinoma, Adenosquamous / Q000737:chemistry / Q000175:diagnosis*; D003593:Cytoplasm / Q000737:chemistry / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D008168:Lung / Q000737:chemistry / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000737:chemistry / Q000175:diagnosis; D009362:Neoplasm Metastasis / Q000473:pathology; D016066:Pleural Effusion, Malignant / Q000737:chemistry / Q000473:pathology*; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor