Book contents
- Frontmatter
- Dedication
- Contents
- Contents
- Contributors
- Foreword to the First Edition
- Preface to the Sixth Edition
- Acknowledgements
- Chapter 1 The normal lung: histology, embryology, development, aging and function
- Chapter 2 Lung specimen handling and practical considerations
- Chapter 3 Congenital abnormalities and pediatric lung diseases, including neoplasms
- Chapter 4 Pulmonary bacterial infections
- Chapter 5 Pulmonary viral infections
- Chapter 6 Pulmonary mycobacterial infections
- Chapter 7 Pulmonary mycotic infections
- Chapter 8 Pulmonary parasitic infections
- Chapter 9 Acute lung injury
- Chapter 10 Interstitial lung diseases
- Chapter 11 Metabolic and inherited connective tissue disorders involving the lung
- Chapter 12 Hypersensitivity pneumonitis
- Chapter 13 Sarcoidosis
- Chapter 14 Occupational lung disease
- Chapter 15 Eosinophilic lung disease
- Chapter 16 Drug- and therapy-induced lung injury
- Chapter 17 Chronic obstructive pulmonary disease and diseases of the airways
- Chapter 18 Pulmonary vascular pathology
- Chapter 19 Pulmonary vasculitis and pulmonary hemorrhage syndromes
- Chapter 20 The pathology of lung transplantation
- Chapter 21 The lungs in connective tissue disease
- Chapter 22 Benign epithelial neoplasms and tumor-like proliferations of the lung
- Chapter 23 Pulmonary pre-invasive disease
- Chapter 24 Epidemiological and clinical aspects of lung cancer
- Chapter 25 Lung cancer staging
- Chapter 26 Immunohistochemistry in the diagnosis of pulmonary tumors
- Chapter 27 Adenocarcinoma of the lung
- Chapter 28 Squamous cell carcinoma of the lung
- Chapter 29 Large cell carcinoma and adenosquamous carcinoma of the lung
- Chapter 30 Salivary gland neoplasms of the lung
- Chapter 31 Neuroendocrine tumors and other neuroendocrine proliferations of the lung
- Chapter 32 Sarcomatoid carcinomas and variants
- Chapter 33 Mesenchymal and miscellaneous neoplasms
- Chapter 34 Pulmonary lymphoproliferative diseases
- Chapter 35 Metastases involving the lungs
- Chapter 36 Diseases of the pleura
- Index
- References
Chapter 2 - Lung specimen handling and practical considerations
Published online by Cambridge University Press: 05 June 2014
- Frontmatter
- Dedication
- Contents
- Contents
- Contributors
- Foreword to the First Edition
- Preface to the Sixth Edition
- Acknowledgements
- Chapter 1 The normal lung: histology, embryology, development, aging and function
- Chapter 2 Lung specimen handling and practical considerations
- Chapter 3 Congenital abnormalities and pediatric lung diseases, including neoplasms
- Chapter 4 Pulmonary bacterial infections
- Chapter 5 Pulmonary viral infections
- Chapter 6 Pulmonary mycobacterial infections
- Chapter 7 Pulmonary mycotic infections
- Chapter 8 Pulmonary parasitic infections
- Chapter 9 Acute lung injury
- Chapter 10 Interstitial lung diseases
- Chapter 11 Metabolic and inherited connective tissue disorders involving the lung
- Chapter 12 Hypersensitivity pneumonitis
- Chapter 13 Sarcoidosis
- Chapter 14 Occupational lung disease
- Chapter 15 Eosinophilic lung disease
- Chapter 16 Drug- and therapy-induced lung injury
- Chapter 17 Chronic obstructive pulmonary disease and diseases of the airways
- Chapter 18 Pulmonary vascular pathology
- Chapter 19 Pulmonary vasculitis and pulmonary hemorrhage syndromes
- Chapter 20 The pathology of lung transplantation
- Chapter 21 The lungs in connective tissue disease
- Chapter 22 Benign epithelial neoplasms and tumor-like proliferations of the lung
- Chapter 23 Pulmonary pre-invasive disease
- Chapter 24 Epidemiological and clinical aspects of lung cancer
- Chapter 25 Lung cancer staging
- Chapter 26 Immunohistochemistry in the diagnosis of pulmonary tumors
- Chapter 27 Adenocarcinoma of the lung
- Chapter 28 Squamous cell carcinoma of the lung
- Chapter 29 Large cell carcinoma and adenosquamous carcinoma of the lung
- Chapter 30 Salivary gland neoplasms of the lung
- Chapter 31 Neuroendocrine tumors and other neuroendocrine proliferations of the lung
- Chapter 32 Sarcomatoid carcinomas and variants
- Chapter 33 Mesenchymal and miscellaneous neoplasms
- Chapter 34 Pulmonary lymphoproliferative diseases
- Chapter 35 Metastases involving the lungs
- Chapter 36 Diseases of the pleura
- Index
- References
Summary
Introduction
The current practice of thoracic pathology extends beyond the routine pathological assessment of a pulmonary specimen and requires teamwork with a multidisciplinary approach. All pathologists – whether practicing in smaller community settings or in a larger academic centers – should facilitate an interactive discussion with their clinical and radiology colleagues. This should occur frequently, as technological advances are made, and as important evidence-based studies are added to the literature. This discussion has utility in all phases of the diagnostic evaluation – before, during, and after the specimen has been submitted to the laboratory. Reluctance on the part of the pathologist to engage in these discussions is often a disservice to the individual patient and an impediment to improving the overall quality of medical care and knowledge. Prior to sampling, the issue might center on what constitutes appropriate pathological sampling and in what context. Is an open lung biopsy necessary in a patient with idiopathic pulmonary fibrosis (IPF)? Given the current trend toward personalized chemotherapy requiring numerous molecular tests, will the amount of material in a needle biopsy be sufficient for diagnosis? Are multiple molecular tests in patients with advanced-stage non-small cell lung cancer needed and if so which ones? Under what circumstances is a cytological diagnosis of mesothelioma reliable and acceptable? During pathological evaluation, clinical and radiographic correlations are absolutely essential. Is the pathological sampling truly representative of the radiographic abnormality? Do the pathological changes account for the patient's symptoms and suspected disease? How can additional ancillary tests, such as immunohistochemistry, help to refine the diagnosis? As a corollary, why is it important for the clinician and patient to wait beyond the usual turnaround time for the final diagnosis? Following the final diagnosis, the discussion might focus on the options for further pathological sampling in the case of a non-diagnostic sampling, as well as the appropriate interval for radiographic follow-up and repeat sampling in stable or progressive disease.
- Type
- Chapter
- Information
- Spencer's Pathology of the Lung , pp. 41 - 65Publisher: Cambridge University PressPrint publication year: 2000