Lung tumors, particularly those located in the central airways (like squamous cell carcinomas), often shed cells into the surrounding mucus. When you cough up sputum, these cells come with it. A pathologist then treats the sample with a Papanicolaou (Pap) stain and examines it under a high-power microscope to look for changes in cell shape, size, and nuclear structure that indicate malignancy.
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