Our group had a satisfactory agreement on the distinction of mild from severe dysplasia and on microinvasive carcinoma without any discussion as to histopathological criteria to be used. Clinical management--review endoscopy, repeat cord stripping, radiotherapy and laryngectomy--is in general dependent on histological assessment. Thus the agreement on categories which underpin clinical management is reassuring. However, assessment of moderate dysplasia remains problematic. An attempt to utilize a two grade system--low grade from high grade dysplasia/CIS--may have merit. The implications of the terminology used must be agreed among pathologists and clinicians working closely within clinicopathological cancer groups.

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Aims-To evaluate the ability of histopathologists to sub-classify non-small cell lung carcinomas on bronchial biopsy material using the current World Health Organisation (WHO) classification. Methods-Twelve histopathologists each reviewed 100 randomly selected bronchial biopsy specimens which had originally been reported as showing non-small cell lung carcinoma. For each case, two sections were circulated, one stained by haematoxylin and eosin and the other by a standard method for mucin (alcian blue/ periodic acid Schifi). The participants were allowed to indicate their degree of confidence in their classification of each case. A standard proforma was completed and the results were analysed using K statistics. Results-Where the participants were confident in their classification, they were actually quite good at sub-classifying the non-small cell carcinoma sections (K = 0-71, standard error=0.058). Overall, however, the results were only fair (K= 0'39, standard error= 0.034). Conclusions-The majority of non-small cell lung carcinomas can be correctly categorised on adequate bronchial biopsy material. Where a confident diagnosis was made, both squamous carcinoma (K = 0.73) and adenocarcinoma (K = 0-83) were well recognised. (J Clin Pathol 1996;49:130-133)

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