Committee I: Indications for pulmonary cytology sampling methods

Abstract

The Papanicolaou Society of Cytopathology has developed a set of guidelines for pulmonary cytology including indications for bronchial brushings, washings and endobronchial ultrasound-guided fine needle aspiration, technical recommendations for cytologic sampling, recommended terminology and classification scheme, recommendations for ancillary testing and recommendations for postcytologic diagnosis management and follow-up. All recommendation documents are based on the expertise of the authors, extensive literature review and feedback from presentations at national and international conferences. This document selectively presents the results of these discussions. The present document summarizes the recommendations for clinical and imaging evaluation of pulmonary lesions along with the indications for cytologic studies regarding these abnormalities. Preprocedural requirements regarding brushing, washing and needle aspiration procedures are discussed also. Diagn. Cytopathol. 2016;44:1010-1023. © 2016 Wiley Periodicals, Inc.

The new guidelines of Papanicolaou Society of Cytopathology for respiratory specimens: Assessment of risk of malignancy and diagnostic yield in different cytological modalities

“…Since only a few sputum samples had corresponding histology, sensitivity and specificity ratios were not found statistically significant. In the literature, the sensitivity is reported 59% in bronchial brush and this ratio was even lower when the lesion is in peripherally located . Similarly, our sensitivity and specificity were 57%‐67% and 100%, respectively.…”

“…The reported sensitivity is 66% (42% to 97%) and specificity is 99% (68% to 100%) for sputum material. As such, sputum is an acceptable method for lung cancer diagnosis, especially for centrally located lesions . Since only a few sputum samples had corresponding histology, sensitivity and specificity ratios were not found statistically significant.…”

Committee II: Guidelines for cytologic sampling techniques of lung and mediastinal lymph nodes

“…The standardized terminology and nomenclature for respiratory cytology have recently been published, along with the consensus recommendations for the utilization of ancillary studies for diagnosis . The following is Committee II report on guidelines for techniques utilized for respiratory sampling that complements the previously published Committee I report on the guidelines for indications of such sampling techniques …”

“…CT‐FNA is a minimally invasive procedure that is used to evaluate various lung lesions, particularly peripheral ones . Transthoracic needle aspiration is able to provide diagnosis of peripheral lung lesions with a diagnostic accuracy in the range of 85%–95% in many studies.…”

Lung cancer samples preserved in liquid medium: One step beyond cytology

“…In this context, liquid cytology might also be potentially used as a specimen for liquid biopsy, which is a less invasive method, easily obtained and likely to be better tolerated than rebiopsy for patients. Another possible use of cytology is the identification of causative agents and management of patients with infectious diseases . Because the lung is the largest epithelial surface in the body, it constitutes the major portal for the entry of microorganisms such as viruses, bacteria and fungal organisms .…”