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Semin Respir Crit Care Med 2013; 34(06): 787-791
DOI: 10.1055/s-0033-1358555
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Tissue Acquisition and Specimen Processing in the Diagnosis of NSCLC

Jason Akulian
1   Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, University of North Carolina in Chapel Hill, Chapel Hill, North Carolina
,
Lonny Yarmus
2   Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, Maryland
,
David Feller-Kopman
2   Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, Maryland
› Author Affiliations
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Publication History

Publication Date:
20 November 2013 (online)

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Abstract

The current management of non–small cell lung cancer (NSCLC) requires pathological differentiation between adenocarcinoma and squamous cell carcinoma using immunohistochemistry and morphological analysis. Additionally, as novel therapies for specific genetic mutation and chromosomal rearrangement profiles in patients with adenocarcinoma are becoming more numerous and clinically available, adequate tissue acquisition and specimen processing have become crucial. Historically, tissue was obtained via mediastinoscopy or video-assisted thoracoscopy (VATS). However, 80% of patients with lung cancer are ultimately found to be nonsurgical candidates. More recently, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been shown to be a safe and potentially superior modality to obtain tissue for diagnosis, staging, and molecular profiling. The preparation of tissue specimens has also been the subject of study as different methods have been shown to increase cellular yield. This is of particular importance as the number of clinically significant targetable mutations and chromosomal rearrangements continues to grow and the need for more tissue increases.

Keywords

lung cancer - non–small cell lung cancer (NSCLC) - mediastinal staging - lymph node - endobronchial ultrasound (EBUS) - epidermal growth factor receptor (EGFR)