Recent advances in pulmonary cytopathology

Our plain-English summary of Recent advances in pulmonary cytopathology, by S.D. Greenberg (Human Pathology, 1983).

The study

• Author: S.D. Greenberg
• Journal: Human Pathology
• Published: 1983;14(10):901-12
• Type of article: Review
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000609).

Abstract

During the past five years, advances in pulmonary cytopathology have made possible the achievement of several goals, including the diagnosis of pneumonias in immunocompromised hosts, the detection and localization of occult lung cancers in high-risk cigarette smokers, the diagnosis of lesions of the lungs and chest wall by fine-needle aspiration, and the detection of asbestos exposure by sputum cytologic studies. Significant progress has also been made in the application of cell image analysis to the detection of premalignant bronchial epithelial cells in sputum. For the most part, these advances are based on such well-known cytologic procedures as the preparation of thin and evenly distributed smears, prompt fixation, properly controlled and monitored Papanicolaou staining, and thorough screening of slides. Such diligence in laboratory techniques remains the backbone of excellence in pulmonary cytopathology. Cytologic findings should be interpreted with the clinical features of each case in mind, for the practice of pulmonary cytopathology remains an art as well as a science.

In plain English

This article was a review by a single author of advances in pulmonary cytopathology, the study of cells from the lungs such as those found in sputum or pleural fluid, over the preceding five years. It did not report a new study of its own. It covered lung cancer screening by sputum, fine-needle aspiration, pleural fluids, asbestos-associated diseases and computer analysis of cells. On asbestos, the review stated, citing earlier studies, that one asbestos body in sputum indicates more than 900 asbestos bodies per gram wet weight of lung. It said that more than 100 asbestos bodies per gram of wet lung tissue indicates occupational exposure, and that malignant pleural mesotheliomas usually occur with lung loads of about 400 per gram. It stated that the cell findings in asbestos-associated lung cancers are no different from those in other lung cancers. The review chose not to discuss serpentine versus amphibole fibers because their cell features are similar. The author concluded that cell findings should be interpreted with each patient's clinical features in mind.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: narrative review of recent advances in pulmonary cytopathology, drawing in places on the author's own experience and earlier studies
• Who was studied: no study population; the article reviewed published work from roughly the preceding five years
• Exposure: asbestos in general, discussed alongside other lung diseases; serpentine and amphibole fiber mineralogy was deliberately not discussed
• Main results:
  • The review stated, citing earlier correlative digestion studies, that one asbestos body in sputum indicates more than 900 asbestos bodies per gram wet weight of lung
  • The review stated, citing earlier work, that in wet lung tissue digests more than 100 asbestos bodies per gram indicates occupational exposure
  • The review reported, citing earlier work, that mild, moderate and severe asbestosis corresponded to wet lung tissue digests of approximately 1,000, 5,000 and greater than 10,000 asbestos bodies per gram, respectively
  • The review reported, citing earlier work, that malignant pleural mesotheliomas usually occur with lung asbestos loads of approximately 400 asbestos bodies per gram wet weight
  • The review stated that coated fibers (asbestos bodies) are neither fibrogenic nor oncogenic, whereas uncoated fibers longer than 10 micrometers and thinner than 2 micrometers are associated with asbestosis, lung cancer (predominately in smokers) and malignant pleural mesotheliomas
  • The review stated that in asbestosis, sputum asbestos body counts correlate well with chest radiograph findings of interstitial and pleural lung disease and with pulmonary function results showing restrictive disease
  • The review stated that in asbestos-associated lung cancers the cell findings are no different from those in non-asbestos-associated lung cancers
  • The review stated that definitive diagnosis of malignant mesothelioma seemed best accomplished by light and electron microscopy of tumor tissue obtained at thoracotomy, with pleural effusion cytology useful in deciding whether an effusion is malignant
  • In the author's experience, computer-derived atypia status index and cell atypia profile measurements of sputum cells were highly accurate and more than 90 per cent reproducible
• The authors' conclusion: The author concluded that cytologic findings should be interpreted with the clinical features of each case in mind, because pulmonary cytopathology remains an art as well as a science
• Limitations the authors state:
  • The author stated that the computer cell analysis methods take too long per specimen to be used yet in mass screening of groups at high risk for lung cancer
  • The author stated that criteria for telling malignant mesotheliomas from metastatic adenocarcinomas had not yet been applied to cells of malignant pleural effusions

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Cytopathology, Lung Cancer, Fine-Needle Aspiration, Asbestos Exposure, Sputum.

Related studies

• Cytopathology of asbestos-associated pulmonary disease — S.D. Greenberg (1985)
• Pulmonary cytopathology of former asbestos workers. Report of the first year — S.D. Greenberg, G.A. Hurst, et al. (1976)
• Pathogenic effects of inhaled particles and antigens — A.C. Allison (1974)
• Investigative techniques in the laboratory study of coal workers' pneumoconiosis: recent advances at the cellular level — J.S. Harington (1972)
• Relative release of interleukin-1 beta and interleukin-1 receptor antagonist by alveolar macrophages. A study in asbestos-induced lung disease, sarcoidosis, and idiopathic pulmonary fibrosis — J.N. Kline, D.A. Schwartz, et al. (1993)
• Dendritic Cells in Human Lung Disease: Recent Advances — J.W. Upham, Y. Xi (2017)

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