Histopathological study of lung malignancies on small biopsies - A tertiary care experience in Central India

Introduction: Lung cancer accounts for 5.9% of all cancer cases and 8.1% of cancer-related deaths in India. In patients with advanced lung malignancies, CT‐guided needle biopsy (CTNB) was conducted as they are less invasive and are preferrable to resection to make a pathological diagnosis. Materials and Methods: Lung malignancies were diagnosed on small biopsies in the Department of Pathology during the period of January 2021 to December 2022, at a tertiary care hospital in state of Maharashtra in India. A retrospective, observational study was conducted on 82 patients with radiologically proven lung malignancies. Amongst 82 cases, 06 cases were inadequate for interpretation and hence excluded from the study. Biopsies were conducted for all cases. Tissue cores of approximate length 1- 1.5 cm were received in 10% formalin in histopathology section which were processed routinely and stained with haematoxylin and eosin stains. Biopsy  specimen  was  considered adequate  when  it  contained  more  than  20  alveoli. Results: The histopathological analysis of these specimens showed Adenocarcinoma (36.84%) as the most common lung tumour closely followed by squamous cell carcinoma (34.21%) Subtypes of adenocarcinoma noted included solid pattern (n= 18, 64.29%), acinar pattern (n= 04, 14.29%), mucinous pattern (n= 03, 10.71%) and micropapillary pattern (n= 03, 10.71%). Small cell carcinoma accounted for 15.79% of all cases followed by non-small cell carcinoma (n= 04, 5.26%) adenosquamous carcinoma (n= 03, 3.95%), and metastasis (n= 03, 3.95%). Conclusion: Due to the advanced nature of presentation and unresectable nature of malignancies in majority of lung cancers, diagnosis of lung tumours heavily relies on small biopsies.