Untreated bronchogenic carcinoma.A clinicopathological study of 250 autopsied cases

Abstract

HE INCIDENCE of bronchogenic carcinoma T as recorded at the Boston City Hospital has been steadily rising since 1900; at present, this type of carcinoma, even untreated, is the type most frequently seen at autopsy.Because more than s/4 of the patients with bronchogenic carcinoma are seen when they are in terminal condition, it has been possible to accumulate 250 cases of untreated carcinoma of the lung from among the 10,859 autopsies performed in slightly less than 11 years, 1945 to 1955.This series of cases is presented as a study in the natural history of bronchogenic carcinoma and as a possible base line against which palliative and temporary therapy might be measured.No attempt was made to review the literature on lung cancer: careful reviews of older28 and more recent'.143 23 material are easily available.Several large studies of autopsy material proved helpful, particularly those of Frissell and Knox,* Maxwel1,lS and Reingold et a1.22 Certainly for a massive general survey of cases of untreated lung cancer, the Fischer chapter in the Henke and Lubarsch series7 is indispensable. METHOD OF STUDYCharts, autopsy protocols, and slides were available on all patients.No patient received more than supportive care.An average of 12 slides for each case were surveyed, with at least 3 of sections from the primary lesion.All sites of metastasis were histologically verified.Hematoxylin and emin or phloxine-methylene blue stains were used.One of the principal intentions of this survey was to evaluate histological classification in the study of lung cancer, at least in so far