Adenosquamous carcinoma of the lung diagnosed by cytology?: a diagnostic dilemma

Diagn Cytopathol. 2012 Sep;40(9):830-3. doi: 10.1002/dc.21664. Epub 2011 Mar 17.

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.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / chemistry
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma of Lung
  • Aged
  • Biomarkers, Tumor / chemistry
  • Biopsy / methods
  • Bronchoalveolar Lavage Fluid / chemistry
  • Carcinoma, Adenosquamous / chemistry
  • Carcinoma, Adenosquamous / diagnosis*
  • Cytoplasm / chemistry
  • Cytoplasm / pathology
  • Diagnosis, Differential
  • Humans
  • Immunohistochemistry
  • Lung / chemistry
  • Lung / diagnostic imaging
  • Lung Neoplasms / chemistry
  • Lung Neoplasms / diagnosis
  • Neoplasm Metastasis / pathology
  • Pleural Effusion, Malignant / chemistry
  • Pleural Effusion, Malignant / pathology*
  • Tomography, X-Ray Computed

Substances

  • Biomarkers, Tumor