TNCCs impacted the cellularity of the sediment smears and Histogel preparations. Cytocentrifuged preparations resulted in the best cellularity and morphology and are, therefore, recommended whenever possible. Neither the Histogel nor the Gelfoam methods demonstrated any advantage over sediment smear preparations, and both performed poorly when compared with cytocentrifuged preparations. Therefore, we do not recommend the use of these methods.
We thank the authors for their comments, and appreciate their insight into strategies for the evaluation of bronchoalveolar lavage (BAL) and transtracheal wash fluids. We agree that an in-house cytocentrifuge is an excellent strategy for preparation of a cytologic sample that preserves cell morphology, and that the substitution of a salad spinner for a conventional cytocentrifuge 1 makes this methodology approachable by essentially everyone. In our experience, an unfortunate limitation is that many practitioners do not have the time necessary for preparation of this type of sample, despite the relative ease of the methodology. A motivation for our work was the hope of identifying an even simpler strategy for sample preservation that would require little time and could be completed with very limited training. In the future, it might be useful to dedicate CE time to teaching veterinarians different strategies for preparation of samples of this type for submission to a laboratory.We agree that a cell-block is not a replacement for cytologic evaluation, but the aim of our study was to determine if a cellblock preparation might be substituted in situations where cell preservation for cytology was the major issue. Unfortunately, this did not prove to be the case. We also agree that the potential to use cell-blocks for immunohistochemical evaluation (and preservation of material for other methods) supports their use in veterinary diagnostic pathology as a valuable adjunct to routine cytologic assessment.Although cell-blocks have proven to be valuable in the diagnosis of neoplastic conditions in people, in our practice, it is unusual to perform a BAL or TTW analysis for diagnosis of neoplastic lung disease.As a result, the group of samples included in our study is biased toward patients with suspicion for inflammatory airway disease. There have been other studies assessing the utility of BAL and TTW for the diagnosis of pulmonary neoplasia with varying results. 2-4 A recent study 4 assessed BALF analysis as a complementary tool for diagnosing lung metastasis in female dogs with mammary tumors. This study found that cytologic features of malignancy were identified in only one dog (out of 30) and thus, BALF analysis was considered to have low sensitivity for diagnosing metastatic mammary tumors in lungs.It would be interesting to perform additional studies in patients suspected of having neoplastic pulmonary disease to assess the utility of cell-block techniques with immunohistochemistry in the diagnosis of these lesions.Our study reinforces the conclusion that cell-blocks should not be recommended for routine analysis of BAL or TTW fluid samples, but we strongly agree that cell-blocks have potential to be a valuable addition to the collection of tools that can be used to assess samples of this type.
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