Respiratory cytology: Differential diagnosis and pitfalls

M.D., F.R.C.P.C. Reda S. Saad; Silverman, Jan F.

doi:10.1002/dc.21205

Cited by 37 publications

(53 citation statements)

References 56 publications

(84 reference statements)

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“…The morphology of AC cell clusters is highly variable. And reactive type II pneumocytes (RPII) undergo hyperplasia and reactive changes in response to injury resulting from various conditions, such as infections, interstitial lung diseases, organizing pneumonia, pulmonary drug toxicity, and tuberculosis (10,(15)(16)(17). A lepidic pattern of AC may be observed in small biopsy specimens but is difficult to diagnose in cytological material (18,19).…”

Section: Discussionmentioning

confidence: 99%

The value of cell block based on fine needle aspiration for lung cancer diagnosis

Dong¹,

Li²,

Zhou³

et al. 2017

J. Thorac. Dis.

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Section: Discussionmentioning

confidence: 99%

The value of cell block based on fine needle aspiration for lung cancer diagnosis

Dong¹,

Li²,

Zhou³

et al. 2017

J. Thorac. Dis.

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“…Cytopathologist needs to be aware of the possible pitfalls and simulators, while viewing the cytosmears of lung cytology to prevent morbidity in false positive diagnosis and delayed treatment with poor outcome in false negative cases. [910]…”

Section: Discussionmentioning

confidence: 99%

Bronchial wash cytology: A study on morphology and morphometry

Rao¹,

Rao²,

Lal³

et al. 2014

J Cytol

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Background:Bronchial wash cytology of lung lesions is a non/minimally invasive procedure utilized for diagnosis of pulmonary lesions.Aim:The aim of this study was to evaluate the efficacy of bronchial wash cytology in the diagnosis of bronchopulmonary lesions and assess the role of morphometry in categorizing dysplastic/malignant lesions.Materials and Methods:All cases of bronchial wash cytology received from January 2006 to June 2010 were retrieved and reviewed. Cases with adequate clinical data or a subsequent biopsy were selected for the study and cytodiagnosis was correlated with available clinical details. Morphometry was done on alcohol fixed hematoxylin and eosin stained cytosmears using computer assisted Image Pro software.Results:One hundred and seventy-six cases of the 373 cases of bronchial cytology received were included for the study. Bronchial wash cytology technique showed high specificity. Cytohistopathology correlation showed 62.06% concordance rate. Cells from normal epithelium, reactive atypia, neoplastic atypia, squamous metaplasia, non-small cell and small cell carcinoma showed a mean nuclear diameter of 7.4 μm, 11.7 μm, 13.9 μm, 13.0 μm, 10.7 μm, and 17.7 μm, respectively, which was statistically significant with P < 0.05. Multiple comparisons between various groups using analysis of variance and Bonferroni tests also showed remarkable statistical significance.Conclusions:Bronchial wash cytology has low sensitivity in detecting pulmonary lesions. It can be of value in patients with contraindication for biopsy. Morphometry can be a useful adjunct to cytomorphology, especially in situations where biopsy is contraindicated.

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“…This may have contributed to the overall accuracy of cell typing by morphology, as evidence of keratinisation is a reliable indicator of squamous differentiation [10]. In contrast, the identification of adenocarcinoma often requires architectural clues that are less often present in cytology samples compared with histology samples and, thus, confident distinction between adenocarcinoma and a less well differentiated squamous carcinoma can pose more problems in cytological samples.…”

Section: Discussionmentioning

confidence: 99%

“…Similar issues exist when assessing cytological specimens, with the added complication that the architectural features that indicate glandular differentiation in histology specimens may not be present, making the distinction between adenocarcinoma and poorly differentiated nonkeratinising malignant squamous cells particularly difficult [10].…”

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confidence: 99%

Accuracy of cell typing in nonsmall cell lung cancer by EBUS/EUS-FNA cytological samples

Wallace

Rassl²

2011

European Respiratory Journal

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Endoscopic ultrasound-guided transbronchial or transoesophageal lymph node aspiration is increasingly used as a method of diagnosing nonsmall cell carcinoma. Data validating the accuracy of cell typing of nonsmall cell carcinoma using these cytological samples has not been assessed.23 samples were identified in Edinburgh, UK and a further 25 in Cambridge, UK, with matching histological samples. The morphological cell type, as assessed on the cytological preparations and cell blocks, was recorded and immunohistochemical staining was performed, where possible, as an adjunct. The final cell type, as assessed by morphology with or without immunohistochemistry, was correlated with that reported in the paired histological samples.Cell blocks with tumour were available in 39 out of 48 cases. The accuracy of cell typing when no cell block was available was four out of nine cases. This increased to 25 out of 39 when a cell block was available, increasing to 33 out of 39 with the addition of immunohistochemistry. The overall accuracy of classification was 37 out of 48 cases.Accurate cell typing of nonsmall cell carcinomas can be performed using endoscopically derived fine-needle aspirates. The importance of obtaining sufficient material for the production of cell blocks is critical in allowing optimal assessment. KEYWORDS: Classification, cytology, fine-needle aspiration, immunohistochemistry, nonsmall cell lung carcinoma E ndobronchial ultrasound (EBUS)-or endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) has been used as a minimally invasive method of sampling mediastinal and hilar lymph nodes as part of the staging process in patients with lung carcinoma [1][2][3][4]. Studies from various centres have demonstrated such techniques to have a high degree of accuracy and diagnostic yield in identifying node involvement by metastatic carcinoma [1][2][3][4]. This has led to increasing popularity over the last few years and the role of EBUS/EUS-FNA has evolved; it is now perceived as being a method of allowing simultaneous diagnosis and staging of lung cancer in one procedure [4].Developments in oncological therapeutics have simultaneously led to the concept of individualised therapy for nonsmall cell lung cancers (NSCLCs) and the recent introduction of new drugs licensed for tumours with nonsquamous histology [5]. This has led to expectations on pathologists to robustly identify squamous and glandular differentiation in small biopsy and cytological samples, when previously the term ''NSCLC, not otherwise specified (NSCLC-NOS)'' would have been sufficient to allow patient management [6].Accurate cell typing of nonsmall cell carcinomas in small diagnostic biopsy specimens has been recognised for many years to present a significant problem to pathologists, given the focal nature of specific diagnostic features and their frequent absence in small diagnostic specimens [7][8][9]. Similar issues exist when assessing cytological specimens, with the added complication that the architectural features that indic...

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Respiratory cytology: Differential diagnosis and pitfalls

Cited by 37 publications

References 56 publications

The value of cell block based on fine needle aspiration for lung cancer diagnosis

The value of cell block based on fine needle aspiration for lung cancer diagnosis

Bronchial wash cytology: A study on morphology and morphometry

Accuracy of cell typing in nonsmall cell lung cancer by EBUS/EUS-FNA cytological samples

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