Pleural fluid:  possitive for adenocarcinoma.

Needle core biopsy;  Malignant tumor.  Cells look like adenocarcinoma showing eccentric nuclei and some cytoplasmic vacuoles.  Pic 2 and 3 show cells growing along the alveolar walls, a feature for bronchoalveolar carcinoma of lung.  However, pic 1 and 4 appear to show stromal invasion.  Whenever you see stromal invasion, you cannot call it BAC anymore.  Also, we are not encouraged to call BAC on needle core or cytology specimens due to the focal nature.  BAC has excellent prognosis and we do not want to mislead the clinicians and patients and give them false hope.

The cells from the fluid and core biopsy appear somewhat different; fluid cells are larger and with more cytoplasm while the needle biopsy cells are smaller and with scant cytoloplam.  Lung cancer is often heterogenous and the needle core may represent only one portion of the morphology of the tumor.

腺癌