Context—Traditionally, lung cancer has been viewed as an aggressive, relentlessly
progressive disease with few treatment options and poor survival. The traditional role of the
pathologist has been primarily to differentiate small cell carcinoma from non–small cell
carcinoma on biopsy and cytology specimens and to stage non–small cell carcinomas that
underwent resection. In recent years, our concepts of lung cancer have undergone a
revolution, including (1) the advent of successful, new, molecular-targeted therapies for lung …

To the Editor.—As we begin the magical, mystery journey into the age of personalized
medicine, molecular-targeted therapy, and tumorspecific therapy, potentially highly relevant,
precise, and detailed diagnostic information gathered over decades is being essentially
ignored. It is quite possible that ultrastructural pathologists have been consistently
describing key morphologic features that will correlate with molecular expression and
therapy. Light microscopy visualizes a portion of the iceberg; the available …