Misclassification of bronchioloalveolar carcinoma with cytologic diagnosis of lung cancer

Dan J. Raz, Jason A. Zell, Anthony Karnezis, Anobel Odisho, S. H. Ignatius Ou, Hoda Anton-Culver, David M. Jablons

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


INTRODUCTION: Cytology is commonly used to diagnose non-small cell lung cancer (NSCLC) but is an inaccurate means of diagnosis of bronchioloalveolar carcinoma (BAC). The aims of this study were to calculate the sensitivity and specificity of cytologic diagnosis of BAC and to estimate the misclassification of BAC as other subtypes of NSCLC. METHODS: Preoperative fine-needle aspiration cytology diagnoses were compared to histology diagnoses in 222 patients, including 51 patients with pure or mixed BAC, who underwent lung resection for NSCLC at our institution since 1999. RESULTS: The sensitivity and specificity of a cytologic diagnosis of BAC were 12% and 99%, respectively. Based on cytologic diagnosis, 63% of BAC was misclassified as adenocarcinoma, and 18% was misclassified as undifferentiated NSCLC. In this cohort, 35% of adenocarcinomas and 12% of undifferentiated NSCLC diagnosed by cytology had BAC histology. CONCLUSIONS: Diagnosis of NSCLC by cytology alone results in significant misclassification of BAC, most commonly as adenocarcinoma or undifferentiated NSCLC. Because patients with BAC respond differently to certain treatments such as endothelial growth factor receptor inhibitors and surgical resection of multifocal lung cancer, misclassification of BAC may have important therapeutic implications.

Original languageEnglish (US)
Pages (from-to)943-948
Number of pages6
JournalJournal of Thoracic Oncology
Issue number9
StatePublished - Nov 1 2006
Externally publishedYes


  • Bronchioloalveolar carcinoma
  • Cytology
  • Epidemiology
  • Lung cancer
  • Misclassification

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine


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