Cytomorphologic features of small cell carcinoma of lung in effusion fluid using a liquid‐based cytology technique

Abstract

Background: Liquid-based cytology (LBC) testing induces morphologic changes due to the use of specific fixatives and preparation techniques, and the cytologies of effusions determined in this manner differ morphologically from those of conventional cytopreparation (CCP) smear methods. We compared the cytologic features of pulmonary small cell carcinoma in effusion fluid using CCP and LBC preparations.Methods: Fifty-three malignant effusion specimens from 36 patients with small cell carcinoma were examined, including 41 LBCs from 27 patients and 12 CCPs from 9 patients.Results: LBC and CCP preparations preserved the typical features of small cell carcinoma, that is, nuclear molding, very high nuclear to cytoplasmic ratio and granular chromatin. The architectural patterns involved small cohesive clusters and chains with nuclear molding, tight three-dimensional clusters, or single cell dispersion were preserved in both preparations. Oval nuclei (83.3% vs 26.8%, P < .001) and a discernable rim of cytoplasm (66.7% vs 26.8%, P = .043) were more frequently identified in CCPs, whereas cellular degeneration and dry artifact were more frequent in LBC preparations (73.2% vs 8.3%, P < .001). LBC had a tendency to show frequent nuclear size variation (51.2% vs 25.0%) than CCP.Conclusion: LBC tends to show more degeneration and dry artifact with exaggerated irregular nuclear shape and nuclear size variation and scanty cytoplasm than CCP.Cytopathologists should be familiar with the cytomorphologic spectrum of this tumor in CCP and LBC prepared effusions. K E Y W O R D Sconventional cytology, effusion, liquid-based cytology, lung cancer, small cell carcinoma

The value of intercluster single cell streaks, triplet signet ring cells, and a two‐cell population in urine small cell neuroendocrine carcinoma

“…However, these doublet/triplet single cells showed crescent stacked moulded nuclei and lacked intracytoplasmic mucin vacuoles. Characteristic streaking commonly seen in aspirate samples is not as prominent in effusion fluids and urine 1,6,7 . However, we found the feature of stretched single cells between clusters a useful clue of intercluster single cell smearing.…”

A Review of Effusion Cytomorphology of Small Round Cell Tumors

“…The 5-year survival is 7–18% for patients with limited disease and 1–3% for patient with extensive disease [53, 56, 57]. SCNC involves the pleura in 20–30% of patients with SCNC, and the involvement of tumor cells in serous body cavity effusions is rare (<3% of cases) [8, 47, 48, 52]. Although uncommon, a malignant pleural effusion can be the initial presentation of SCNC [52].…”

“…The background frequently shows reactive mesothelial cells, lymphocytic inflammation, karyorrhexis, frequent mitotic figures, apoptosis, and possible necrotic debris [1, 47, 48, 58]. Small vertebral column-like cohesive chains, small onion skin-like clusters, and 3-dimensional tight cluster patterns are frequent and have been reported as characteristic features of SCNC in effusion specimens [8, 47, 58]. These cohesive clusters of tumor cells are at times difficult to visualize due to the nuclear overlap [8, 48].…”

“…These cohesive clusters of tumor cells are at times difficult to visualize due to the nuclear overlap [8, 48]. Nuclear molding is present in most cases [1, 8, 48, 52, 58], and the molded nuclei around the periphery of the tumor cell clusters can be a helpful finding [8]. Cytomorphologically, the tumor cells are small; the nuclei are approximately 2–3 times larger than mature lymphocytes [47, 48].…”

“…One of the major benefits of analyzing fluid cytology for SRCTs is the variety of slide preparation methods that are available. Fluid samples can be used to prepare smears (alcohol-fixed and air-dried), thin-layer preparations, cytocentrifuge preparations, and formalin-fixed paraffin embedded cell blocks [7, 8]. The variability of preparations allows for an increase in sensitivity of tumor detection and allows for helpful ancillary testing.…”