Rinse fluid and imprint smear cytology of bronchial biopsies in diagnosis of lung tumors

Abstract

The usefulness of rinse fluid and imprint smear cytology of the bronchial biopsy has been studied in diagnosis of lung cancer. However, scarce data is available regarding rinse fluid cytology of biopsy. The aim of this study was to evaluate these cytologic techniques for their diagnostic accuracy. Bronchial biopsy was taken in 52 patients clinically/radiologically suspected to have lung carcinoma. Imprint smears of the biopsy were prepared, following which it was put in balanced saline solution to collect rinse fluid of biopsy before transferring it to formalin for fixation. Cytological diagnosis from imprint and rinse fluid smears was compared with histopathological diagnosis. Malignancy was detected in 45 cases of 52 patients on histopathology. Positive result was given by rinse fluid cytology in 34 (65.4%) cases while diagnostic accuracy was 78.8%. The imprint smears were positive for malignancy in 44 (84.6%) cases with diagnostic accuracy of 98.08%. There were no false-positive results, but one case was incorrectly typed by both the techniques. Imprint smear cytology has a better diagnostic accuracy and efficacy over rinse fluid while the two cytologic techniques can be used in combination routinely with biopsy to provide an early and reliable diagnosis in lung cancer.

The Role of Squash Cytology in Rapid On-Site Adequacy Checking and Rapid Diagnosis in Image-Guided Gun Biopsy at a Tertiary Cancer Center

“…These values are comparable to some of the studies in the literature and are even better than some (table 5) [6,7,8,9,10,11,12,13,14,15,16]. It should be pointed out here that biopsy diagnosis is attained after immunohistochemistry which was not possible on cytology.…”

“…In most of the studies, imprint cytology is used as a technique for on-site adequacy checking with an adequacy rate in the range of 94-98% (table 5) [6,7,8,9,10,11,12,13,14,15,16]. …”

Usefulness of imprint and brushing cytology in diagnosis of lung diseases with flexible bronchoscopy

“…A possible explanation for these two cases of false negative histology is that sometimes it is technically and anatomically impossible to reach exactly the same area for biopsy with brush and forceps, that is, the brush is more flexible and might reach more peripheral compared with the more rigid forceps. An obvious explanation for false negative results of imprint cytology is the low frequency of tumour cells or that the biopsy pieces were imprinted on the glass slides with the wrong side 12. Other factors which affect imprint quality include speed of imprinting and thickness of specimen, bloody smear, large areas of necrosis, extensive fibrosis, fatty tissue or poor differentiation of tumour 12 13…”

“…An obvious explanation for false negative results of imprint cytology is the low frequency of tumour cells or that the biopsy pieces were imprinted on the glass slides with the wrong side 12. Other factors which affect imprint quality include speed of imprinting and thickness of specimen, bloody smear, large areas of necrosis, extensive fibrosis, fatty tissue or poor differentiation of tumour 12 13…”

Nicotine Augments Glomerular Injury in a Rat Model of Acute Nephritis

“…Endothelial dysfunction occurs early in the pathogenesis of atherosclerosis [5, 6]. We have shown that stable reactive aldehydes present in cigarette smoke promote endothelial dysfunction by increasing the production of NADPH oxidase-derived reactive oxygen species (ROS) [7, 8]. …”