Comparison of conventional smear and liquid-based cytology preparation in diagnosis of lung cancer by bronchial wash and transbronchial needle aspiration

Abstract

Introduction:Liquid-based cytology (LBC), initially developed for screening gynecologic specimens, is now being used in nongynecologic aspiration and exfoliative specimens. In this study, the diagnostic yield and utility of thin-prep (TP) was compared with conventional preparations to ascertain its utility in improving the diagnosis of respiratory lesions.Materials and Methods:Bronchial washings (BW) and transbronchial needle aspirates (TBNA) (bronchoscopy/endobronchial ultrasound-guided) from 70 consecutive patients of mediastinal masses and endo/peribronchial growths were included. The diagnostic yields of both conventional smears and thin-prep were compared. Immunocytochemistry (ICC) was performed on direct/cytospin smears of TBNA/BW and TP slides when the tumor could not be subtyped by morphology. Histopathologic correlation was done.Results:Although well-preserved morphological features and cleaner background in TP allowed accurate diagnosis of malignancies, diagnostic yield was comparable to conventional preparations. Immunocytochemistry was successfully employed on TP smears which helped in accurate subtyping of the tumors. Few shortcomings of TP smears were uneven distribution of cells, thick cell clusters, and inadequate cellularity.Conclusion:Liquid-based TP preparation is an effective diagnostic tool for respiratory tract cytology, however, results are comparable to conventional smears.

Lung molecular cytopathology: EGFR and beyond

“…[ 1 ] In advanced stage of the LC, the diagnosis is based on the analysis of cytology samples, especially FNA or bronchial brushings/washings obtained through minimally invasive procedures. [ 11 12 13 14 15 ] Although formalin-fixed samples give good results with molecular tests, formalin is also associated with some important drawbacks, including poor quality of nucleic acids due to structural damage and fragmentation in the process of DNA extraction. [ 16 17 ] All cytology preparations are non-formalin-fixed, hence provide the best alternative source of well-preserved DNA.…”

“…Unstained direct smears, alcohol-fixed Papanicolaou-stained, and air-dried Diff-Quik or Giemsa-stained smears can be used for molecular testing. [ 14 15 ] DNA is readily extractable from all the different cytologic preparations and reasonably stable (from 6 months to 5 years). In both stained and unstained preparations, the number of intact nuclei that are suitable for FISH analysis is also higher.…”

Optimization of Sample Preparation Using Glass Slides for Spectral Pathology

“…Smears can lead to uneven distribution of cells, thick cell clusters, and inadequate cellularity. 7 However, morphological preservation seems better in smears than in cytospins. 8 On the other hand, cytospins provide cellularity even in cases where smears show unsatisfactory cellularity, increasing the diagnostic potential.…”

Tru-cut/core biopsy versus FNAC: Pulmonary tumors

“…Needle rinses of aspiration needle can used for preparing cell blocks or cytospin smears. [ 6 13 ] Rapid on-site evaluation (ROSE) has emerged as a powerful tool in triaging thoracic FNA specimens. It is used not only for adequacy judgement but also for establishing preliminary diagnosis of cancer versus non-cancer.…”