Sputum Cytology in Diagnosis of Maxillary Sinus Cancer

Positive cytology of the sputum of two patients undergoing screening tests for lung cancer led to a diagnosis of cancer of a maxillary sinus.Case 1 was a 55-year-old male who had been treated for chronic bronchitis for several months. His sputum cytology was class V. Roentgenographic and endoscopic examinations of the lower airway showed no abnormalities, but MRI revealed an abnormal shadow in the left maxillary sinus. Open biopsy of the maxillary sinus was performed under general anesthesia. Hsstological examination showed squamous cell carcinoma.Case 2 was a 57-year-old male who had a cytological test of his sputum as part of a routine physical examination. The result was class IIIb. No malignancy was seen in roentgenographic and endoscopic examinations of the lower airway but CT revealed an abnormal shadow in the right maxillary sinus. Biopsy of the maxillary sinus lesion was performed under general anesthesia, and histological examination showed a papilloma with a tiny focus of squamous cell carcinoma.We examined the sputum cytologically in three other patients with maxillary sinus cancer and three with recurrences of this malignancy. Malignant cells were found in the sputum samples of two of the three patients with untreated advanced maxillary sinus cancer and in the sputum of two of the three with recurrent maxillary sinus cancer.The authors conclude that cytological examination of the sputum is useful in the diagnosis of head and neck cancer.