Ultrastructural heterogeneity of pulmonary scar adenocarcinomas: correlation with patients' survival.

A prospective study of 24 pulmonary scar adenocarcinomas was conducted to evaluate a potential correlation between patients' survival, propensity to metastasize, and subtypes of pulmonary scar adenocarcinomas as determined by ultrastructural examination. Ultrastructural studies of pulmonary adenocarcinomas have shown three types of cells: mucus, Clara, and alveolar, with neoplasms exhibiting these cellular components either singly or in combination. Previous studies of adenocarcinomas have revealed that tumors with Clara and alveolar cell differentiation have a better prognosis than those with a mucus cell component. The present study emphasizes clinico-pathologic correlations and indicates that pulmonary scar adenocarcinomas represent a heterogeneous group with a similar cell distribution as has been found in other pulmonary adenocarcinomas. The previously established correlation between cell types and survival remains true in this group of pulmonary adenocarcinomas. Light microscopic growth patterns and special stains (PAS and mucicarmine) were not predictable in identifying the different varieties of pulmonary adenocarcinomas.