Analysis of ThinPrep cytology in establishing the diagnosis of small cell carcinoma of lung

Abstract

BACKGROUND:ThinPrep liquid‐based cytology (TP) preparations are being used increasingly in nongynecologic specimens. To the authors' knowledge, few studies to date have evaluated TP cytology in the setting of small cell carcinoma of the lung (SCCL). Accurately differentiating SCCL from other lung tumors has important clinical and therapeutic implications. Herein, the authors evaluated the diagnostic utility and cytomorphology of TP in the setting of SCCL.METHODS:All cases of SCCL with prior or concurrent TP cytologic specimens were identified via computer search. The cytodiagnoses were tabulated. When available, cytologic material was reviewed. Performance parameters of the various cytologic modalities processed with TP were calculated.RESULTS:In 121 patients with SCCL, 261 TP specimens were identified. The cytodiagnoses were: SCCL (119 specimens), suspicious for SCCL (45 specimens), atypical cells‐not otherwise specified (22 specimens), negative/nondiagnostic (63 specimens), and nonsmall cell carcinoma (4 specimens). During the same period of time, 3 cases of false‐positive diagnoses of SCCL were identified. The positive predictive value for a cytodiagnosis of SCCL on TP was 97.5%, and the sensitivity was 62.8%. Bronchial brush was the most sensitive cytologic modality (78.3%). Immunostaining was found to be contributory to the diagnosis in 10 of the 11 cases in which it was attempted.CONCLUSIONS:TP is a sound alternative to conventional preparations for the cytodiagnosis of SCCL. Cytomorphology of SCCL is altered in TP with less molding, less cell fragility, more discohesion, and tumor cell shrinkage artifact. Immunohistochemical staining of cellblocks is a useful adjunct in challenging cases. A positive cytodiagnosis of SCCL on TP can be used to initiate definitive therapy when biopsy is not possible. Cancer (Cancer Cytopathol) 2009. © 2009 American Cancer Society.

Conventional vs. Liquid Based Cytology in Fine Needle Aspirates of Lung and Mediastinal Masses

“…Morphologically we found that smearing and molding were less pronounced in LBC smears in small cell carcinoma lung and some amount of cellular elongation was observed in these cases [19]. The above observation is due to suspension of cells in liquid media.…”

Do Liquid-Based Preparations of Pulmonary Bronchial Brushing Specimens Perform Differently From Classically Prepared Cases for the Diagnosis of Malignancies? Observations From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology

“…2015;139:178-183; doi: 10.5858/ arpa.2013-0282-CP) P ulmonary bronchial brushing (BB) is one of the most sensitive cytological procedures for diagnosing lung cancer. [1][2][3] Specimens obtained by BB can be processed by conventional methods or by liquid-based preparations (LBPs). Although conventional methods are inexpensive, the quality of processing depends heavily on the skills of the individual laboratory staff member.…”

“…4 In contrast, LBPs generally preserve most cellular details, produce uniform results, and are generally easier to standardize. 2,3 However, cells and cellular groups may round up in LBPs and generate hyperchromatic cells and groups that are difficult to visualize and interpret.…”

“…3 While LBPs preserve the major characteristics of cellular morphology in nongynecologic samples, artifacts from processing have been reported. 2,3 It remains unclear whether LBPs perform as well as conventional methods with respect to diagnosing lung malignancies in BB samples.…”

“…3 Small cell carcinoma of the lung was accurately diagnosed by LBPs, with a positive predictive value of 97.5%. 2 These initial studies suggested that it may be feasible to substitute LBPs for conventional methods to diagnose lung malignancies from BB samples. Liquid-based preparations may decrease interpretation time, improve the quality of cytological results, and reduce variability between operator readings.…”