Comparison of FNAC smears, cytospin smears, and cellblocks of transthoracic guided FNAC of suspected lung tumor: A study of 100 cases

Abstract

Introduction:Transthoracic guided fine needle aspiration cytology (FNAC) of clinically suspected lung tumors is an increasingly common procedure in diagnosis. Cytospin Smear and Cellblock preparations of available material are helpful in subtyping and confirming the diagnosis, and they can also be used for further studies, i.e., special stain and immunohistochemistry, etc.Aims and Objectives:This research was undertaken to study the technique of guided transthoracic lung FNAC of clinically suspected lung tumors and the establish role of FNAC smears, cytospin smears, and cellblocks in the detection and typing of neoplastic lung lesions and correlation.Materials and Methods:Guided FNAC was taken from 100 cases of clinically suspected lung tumor and FNAC smears, cytospin smears, and cellblocks of aspirated material were studied over a period of 2 years from September 2011 to September 2013.Results:The material adequacies were 80% in FNAC smears, 83% in cytospin smears, and 89% in cellblocks. Additional information supported by cytospin smear and cellblock was 3% and 9%, respectively. Architectural preservation was better in FNAC smears (85%) and cellblocks (73.03%) than that in cytospin smears (31.33%). Morphological preservation was better in FNAC smears (90%) and cellblocks (75.28%) than that in cytospin smears (14.46%). Diagnostic accuracy was increased in the cellblocks and cytospin smears.Conclusion:Cytospin smear was helpful when low cellular material was obtained, and the concomitant examination of cellblocks not only confirmed the diagnosis of malignancy but also helped in classifying the obtained material and allowed further study on the same.

Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies: Guideline From the College of American Pathologists in Collaboration With the American College of Chest Physicians, Association for Molecular Pathology, American Society of Cytopathology, American Thoracic Society, Pulmonary Pathology Society, Papanicolaou Society of Cytopathology, Society of Interventional Radiology, and Society of Thoracic Radiology

“…Cytology laboratories use a wide variety of collection media, fixatives, and stains for specimen preparation. A wide range of cytology specimen processing techniques were identified in the systematic review, including CytoLyt (Hologic Inc, Marlborough, Massachusetts), [141][142][143] Hanks, 44 RPMI, 144 saline, 111,132,[145][146][147][148][149][150][151][152][153][154][155] and CytoRich (Becton, Dickinson and Company, Franklin Lakes, New Jersey) 43 as collection media; alcohol, 6,46,115,156 formaldehyde, 112 Mount-Quick, 119 and formalin || as fixatives; and Diff-Quik, 6,44,46,166 Giemsa, 43 and Papanicolaou for staining. 46,167 However, none of the listed studies performed direct comparisons between the different processing techniques that enable making a specific recommendation for the use of one method over another.…”

Management of cytologic material, preanalytic procedures and biobanking in lymph node cytopathology

“…With reference to LN non‐small‐cell‐lung cancer) metastases can be accomplished on cytospin and LBC by morphology and ICC. The following step is the selection of adequate material for molecular testing and therapeutic selection, namely for Epidermal growth factor receptor (EGFR), Ki‐ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS), Anaplastic lymphoma kinase (ALK) assessment and emergent programmed death‐1 (PD‐1) e programmed death‐Ligand 1 (PD‐L1) target therapies are being applied in several types of cancer . Recent works have assessed the possibility to evaluate PD‐L1 expression in primary and metastatic non‐small‐cell‐lung cancer cytology samples (cell block), including transbronchial needle aspiration (TBNA) of mediastinal LNs, and FNC of peripheral LNs with reliable results …”

"Diagnostic Significance of Fine Needle Biopsy and Cell Block in Skin and Subcutaneous Nodules"

“…Easy access to skin nodules provides a good platform for performing fine needle cytology and sampling by pathologists or clinicians. Smear cytology gives several default settings [5]. Depth is more important than width.…”