Cytology has been reported to have suboptimal sensitivity for detecting pancreatobiliary tract cancer in biliary tract specimens partly as a result of low specimen cellularity and obscuring noncellular components. The goal of this study was to determine if the use of a glacial acetic acid wash prior to processing would increase the cellularity and improve the quality of ThinPrep slides when compared to standard non-gyn ThinPrep processing. Fifty consecutive pancreatobiliary tract specimens containing 20 ml of sample/PreservCyt were divided equally for standard non-gyn ThinPrep (STP) and glacial acetic acid ThinPrep processing (GATP). A manual drop preparation was also performed on residual STP specimen to determine the number of cells left in the vial during STP processing. Twenty-six (52%) specimens had more epithelial cell groupings with the GATP methodology while 19 (38%) had equivalent cellularity with both methods. The STP method produced more epithelial cell groupings in 5 (10%) of the specimens. Of the 26 specimens that had less cells with the STP method, 14 (54%) had > or = 50 cell groupings on the manual drop slide processed from the residual STP specimen suggesting that many cells remain in the vial after STP processing. The GATP method was preferred in 25 (50%) of the specimens, the STP method in 5 (10%), while both methodologies provided similar findings in the remaining 20 (40%) of specimens. The data from this study suggests that the GATP method results in more cells being placed on the slide and was preferred over the STP method in a majority of specimens.

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BACKGROUND “Small cells” have been described in the cervical‐vaginal (Papanicolaou [Pap]) smears of patients receiving tamoxifen. The current study determined the frequency of this finding and its implications for the differential diagnosis. METHODS A computer‐based search of the cytopathology files from January 1994 to December 1998 was performed for Pap smears from patients with a history of tamoxifen treatment. All smears were reviewed for the presence of “small cells” and endometrial cells. Pap smears from an age‐matched control group that was not treated with tamoxifen also were screened for “small cells.” RESULTS Five hundred forty‐eight Pap smears were identified from 425 patients (mean age, 62 years; average duration of treatment, 43 months). Clusters of these “small cells” were present in 104 Pap smears from 86 patients (19%). The background pattern was proliferative in the majority of the Pap smears (83%). In five Pap smears (5%), these “small cells” were interpreted originally as endometrial cells. In the remaining Pap smears, no reference to the presence of the cells was made in the original report. “Small cells” were identified in 79 Pap smears (18%) in the control group (n = 443 smears). CONCLUSIONS The incidence of “small cells” is similar in the Pap smears of patients with or without a history of tamoxifen treatment. These cells are similar to reserve cells noted in atrophic smears. However, as a result of the proliferative effect of tamoxifen in the cervical epithelium, these cells are prominent when admixed with superficial and intermediate cells in patients treated with tamoxifen. These cells need to be differentiated from endometrial cells to avoid unnecessary follow‐up procedures. Cancer (Cancer Cytopathol) 2001;93:23–28. © 2001 American Cancer Society.

To evaluate the accuracy of a Chlamydia diagnosis in our laboratory, cytologic Chlamydia diagnoses for the years 1990 and 1991 were compared with immunofluorescent studies for Chlamydia for the same period. Only one of 22 cases diagnosed cytologically as suggestive of Chlamydia had a positive immunofluorescent result. On rescreen of 110 cervicovaginal smears taken within 1 mo of a positive fluorescent antibody test, 11 cases were found to contain criteria suggestive of Chlamydia. These correlations represent a 4.5% specificity and 10% sensitivity rate, suggesting that our current efforts in cytology are not effective in determining the presence of Chlamydia.

The incidence of "small cells" is similar in the Pap smears of patients with or without a history of tamoxifen treatment. These cells are similar to reserve cells noted in atrophic smears. However, as a result of the proliferative effect of tamoxifen in the cervical epithelium, these cells are prominent when admixed with superficial and intermediate cells in patients treated with tamoxifen. These cells need to be differentiated from endometrial cells to avoid unnecessary follow-up procedures. Cancer (Cancer Cytopathol)