Pathology of bronchogenic carcinoma in long-term survivors

The pathologic features of 94 cases of bronchogenic carcinoma in patients who survived for 5 years or longer after resection are reviewed. The incidence of squamous cell carcinoma is 56% and parallels that for the entire group of 358 resected cases. There were no survivors with oat cell carcinoma but bronchiolo-alveolar cell carcinomas were found frequently and more than half of the tumors were located peripherally or in an intermediate zone. One of the long-term survivors had a characteristic giant cell carcinoma which had metastasized to regional lymph nodes and appears to represent the first such case recorded in the literature. Metastasis to lymph nodes was recorded in 28% of the cases. All slides were examined on six occasions, leading to considerable discrepancy in the classifications. Problems arose especially in the definition of adenocarcinomas versus bronchiolo-alveolar cell carcinomas but also in the classification of squamous cell and undifferen bated carcinomas.