Improved Method for Inflated-fixed Lung in Lung Cancer

For precise interpretation of radiological findings, Heitzman's inflated-fixed lung method is important. This method, however, has the significant disadvantage of bad staining; pyknosis, detachment of cilia and lack of clarity of cytoplasm. We developed an improved method in small lungs of canines by fixation and distension with formalin prior to the original method in order to obtain both high quality of staining and radiographs. But in some human specimens, we could not obtain satisfactory results. In the present study we assessed the suitable fixation time for lung cancer specimens using this method. Ten resected lobes of peripheral type lung cancers were examined. Fixation times assessed were 15 minutes in 1 case, 3 to 4 hours in 4, and 2 to 4 days in 5. The staining and the radiographs of the specimen were compared to those of the original method and CT. In the specimens of fixation for 15 minutes, there were both areas of good and bad staining within them and good radiographic findings were obtained. In the other cases, staining was satisfactory, but specimens shrank in the two cases of fixation for 3 and 4 days. Fixation and distension with formalin for 3 or 4 hours prior to performing the original method yielded both high quality staining and radiographs of the specimen.