Comparison of ThinPrep and TriPath PREP liquid‐based preparations in nongynecologic specimens: A pilot study

Abstract

ThinPrep (TP) and TriPath PREP (TriP) are two liquid-based cytologic preparations that produce a thin layer of cells. This study compares the diagnostic accuracy and different cytomorphologic alterations produced by these preparations in nongynecologic specimens. Samples from 10 urines (3 urothelial carcinomas and 7 negative), 4 positive serous fluids, and 7 fine-needle aspirates (FNAs) were prepared by both techniques. FNAs represented one each of: Hashimoto's thyroiditis (HT), hyperplastic colloid nodule (HCN), Hodgkin's lymphoma, liposarcoma, chondrosarcoma, squamous-cell carcinoma (SCC) metastatic to the lymph node, and carcinoid tumor. All 5 participants, none of whom had prior knowledge of the clinical history or histologic diagnosis, reviewed and interpreted the slides. Both techniques produced a clean background and were equally accurate in urines, serous fluids, and three FNAs. TriP was slightly more accurate in four FNAs: HCN and HT where colloid and lymphocytes were better represented, SCC where keratin and malignant cells were more readily identified among lymphocytes, and carcinoid which was easier to evaluate on TriP due to less cellular shrinkage and more dispersion of cells between aggregates. TP preparations had more cell shrinkage, and the chromatin was harder to evaluate. Both techniques produced artificial aggregations of lymphocytes, but TriP had a more evenly dispersed single-cell population between aggregates, rendering them easier to evaluate for atypia. TP produced fragmentation of large sheets that were flattened, while TriP contained larger branching sheets in a three-dimensional (3-D) configuration. TP produced a true monolayer of cells that were all spread at the same plane, while in TriP the cells were spread at slightly different planes, requiring frequent focusing of the viewed plane. While both techniques are acceptable for diagnostic purposes, they both introduce new cytomorphologic alterations that pathologists need to recognize. TriP seems superior to TP in FNAs specimens where preservation of architecture and cellular integrity are important considerations.

A Pilot Study Evaluating Liquid-Based Fine Needle Aspiration Cytology of Breast Lesions: A Cytomorphological Comparison of SurePath® Liquid-Based Preparations and Conventional Smears

“…This structural alteration was demonstrated in both benign and malignant breast lesions in the current study (p < 0.001, respectively). Although there is no comparable previous study of SP-based breast cytology, three-dimensional configurations of cell clusters have been observed in a few studies of nongynecologic FNACs [22,23]. Jung et al [23] reported that the SP procedure showed an increase in clustered tissue fragments that caused difficulty in the assessment of nuclear features compared with CS in thyroid FNAC.…”

“…Considering the technical aspects of SP preparation, in our opinion, the presence of cell groups arranged in three-dimensional clusters might be a characteristic finding of the LBP method. In a valuable analysis comparing SP and TP, Michael et al [22] described a prominent three-dimensional configuration in SP compared with considerable flattening of cell clusters with the TP method. The authors mentioned that this is probably due to the discriminative methodology of the two preparations, while the SP-based preparation is processed by simple sedimentation of cells on the slide without compression, TP involves positive pressure applied to the cylinder during cell transfer that results in true monolayer sheets [22].…”

“…Although TP and SP procedures for FNAC are the two most commonly used LBP methods and both show considerable diagnostic accuracy [19,20,21], it is necessary to recognize that breast FNAC samples processed with the SP technique exhibit several cytomorphological alterations compared with the TP technique [22]. In addition, SP subtly appeared as an easier method for cytology interpretation than TP [22].…”

Overview of Nongynecological Samples Prepared with Liquid-Based Cytology Medium

“…The conclusion of this study was that SP seemed superior to TP in FNA specimens where preservation of architecture and cellular integrity were important considerations [32]. …”

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

“…For example, diagnostic cells are famously smaller in TP. [3][4][5] In thyroid cytology, several alterations have been reported, including reduction and alteration in colloid, decreased pseudo-inclusions in cases of papillary cancer, and difficulty recognizing Hashimoto thyroiditis in TP compared with CPs. 3,6 Despite these alterations, several large studies have proven that TP is at least equivalent to CPs in diagnostic accuracy and is a safe alternative to CPs in thyroid cytology.…”