Elsevier

Human Pathology

Volume 16, Issue 6, June 1985, Pages 569-579
Human Pathology

Lung cancer heterogeneity: A blinded and randomized study of 100 consecutive cases

https://doi.org/10.1016/S0046-8177(85)80106-4Get rights and content

The heterogeneity of lung carcinomas was recognized in the past, but few previous studies attempted to quantitate this heterogeneity. In the present study 100 consecutive cases of lung carcinoma (65 surgical resections and 35 autopsies) were collected, and either the entire tumor or ten blocks were examined in a blinded and randomized fashion using the revised (1981) WHO classification. At least three of five panelists agreed on the major histologic type present for 94 per cent of the slides. Agreement for the diagnosis of small cell carcinomas (at least four of five observers) was 98 per cent, but only 72 per cent agreement was attained for the subtyping of small cell carcinomas (e.g., oat cell versus intermediate). Only 34 per cent of the cases were homogeneous according to the majority of the panelists. An additional 21 per cent of the cases showed minor (subtype) heterogeneity (e.g., mixtures of acinar and papillary patterns in adenocarcinoma). Forty-five per cent of the cases showed major heterogeneity, i.e., at least one slide from the case showed a major histologic type different from that of the remainder. Seven small cell carcinomas were homogeneous, whereas in eight cases mixtures of small cell and other cell types were seen. In all but one of the cases involving bronchioloalveolar cell patterns, other patterns of adenocarcinoma were present elsewhere in the tumor. In all six cases involving giant cell carcinoma patterns, adenocarcinoma patterns were also present in some sections. Heterogeneity was identified by extensive sampling of the entire tumor and was seldom recognized in biopsy specimens.

References (33)

  • SidhuGS et al.

    Oat cell carcinoma of the lung and colon (abstract)

    Lab Invest

    (1978)
  • ChurgA et al.

    Small cell squamous and mixed small cell squamous—small cell anaplastic carcinomas of the lung

    Am J Surg Pathol

    (1980)
  • SabaSR et al.

    Carcinomas of the lung: an ultrastructural and immunocytochemical study

    Am J Clin Pathol

    (1983)
  • HessFG et al.

    Pulmonary cytology: current status of cytologic typing of respiratory tract tumors

    Am J Pathol

    (1981)
  • OlcottCT

    Cell types and histologic patterns in carcinoma of the lung: observations on the significance of tumors containing more than one type of cell

    Am J Pathol

    (1955)
  • ReidJD et al.

    The validity and value of histological and cytological classifications of lung cancer

    Cancer

    (1961)
  • Cited by (202)

    • Prognostic significance of dynamin-related protein 1 expression in advanced lung adenocarcinoma

      2022, Pathology Research and Practice
      Citation Excerpt :

      Analysis of biopsy samples obtained under regular clinical diagnostic practice showed that P(S616)-DRP1 expression in cancer cells is not significantly associated with the prognosis of patients with advanced lung adenocarcinoma. However, studies have demonstrated heterogeneity among solid cancers [34,35], and different sampling sites may affect the quantification of P(S616)-DRP1 in cancer cells, resulting in bias on prognostic significance. Second, studies have demonstrated that DRP1 may have role in regulating the chemoresistance of colorectal and gynecologic cancers [36,37].

    View all citing articles on Scopus
    *

    Received from the Department of Pathology Duke University and the Durham Veterans Administration Medical Centers, Durham, North Carolina

    Received from the Department of Pathology, Baylor College of Medicine, Houston, Texas

    Received from the Department of Pathology Veterans Administration Medical Center, West Haven, Connecticut.

    View full text