PART TWO
Diagnostic Cytology
Table 13.20 Total Respiratory Cytopathologic Specimens on Which the
Study Was Based
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Table 13.21 Total Group of Histologically Confirmed Cancer on Which the
Study Was Based
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Table 13.22 Role of the Number of Cytopathologic Specimens in Diagnosis (516 Patients with at Least One Satisfactory Specimen)
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had metastatic cancers to the lungs or malignant neoplasms of
adjacent sites. Tables 13.22 through 13.25 summarize the rela-
tive roles of specimen number and type in the diagnosis of lung
cancer. Of accepted lung cancer, at least one satisfactory cytologic
specimen was examined in 516 cases (Table 13.22). The first
specimen was diagnostic of cancer in 177 patients, or 34.3% of
the total. Examination of five satisfactory specimens resulted in
conclusive diagnoses of cancer in 330 patients, or 63.9% of the
total. Tables 13.23 and 13.24 define more specifically the impor-
tance of the use of multiple cytologic specimens in establishing
a definitive diagnosis of cancer. A total of 424 patients with cyto-
logic findings diagnostic of cancer had had at least three satisfac-
tory specimens submitted (see Table 13.23). The cancers were
diagnosed on the first specimen in 41.7% of these cases. The
submission of three specimens detected a total of 69.5%. From
Table 13.24, one can obtain the diagnostic advantage gained by
increasing the satisfactory specimen count to five.
A minimum of five satisfactory cytologic specimens had been
obtained from 381 patients with cytologic findings diagnostic of
cancer. From five satisfactory specimens, a cytologic diagnosis
of cancer was made in 86.6% of these patients. The relation-
ship between sputum and bronchial material in the diagnosis of
lung cancer is shown in Table 13.25. In 168 patients (41.7% of
357 patients with cytopathology diagnostic of cancer), sputum
only revealed malignant cells and bronchial material in only 93
(26.0%). Both sputum and bronchial material were diagnostic
of cancer in 96 patients (26.9%). The first specimen of sputum
was found to reveal malignant cells in 27.2% of the patients and
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