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Lee WY, Wang HC, Tien KJ. Cytomorphological comparison of ThinPrep and SurePath liquid-based cytology in thyroid fine-needle aspiration. Diagn Cytopathol 2024; 52:217-224. [PMID: 38217259 DOI: 10.1002/dc.25274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The two widely established systems for liquid-based cytology (LBC), ThinPrep and SurePath, employ different principles. The aim of this study was to compare the cytomorphology of thyroid lesions prepared by the two techniques. METHODS We retrospectively reviewed 44 thyroid FNA specimens prepared by LBC, including 20 ThinPrep and 22 SurePath. Cytologic diagnoses were made according to the Bethesda system and cytomorphologic parameters were evaluated. RESULTS Acellular smears were significantly frequent in ThinPrep than SurePath (10% vs. 0%). Both techniques produced a clean background, well cell preservation, and not apparent cell shrinkage. ThinPrep showed significantly lower cellularity than SurePath (25% vs. 4.3%). ThinPrep produced considerable flattening and fragmented clusters, while SurePath contained larger clusters in a three-dimensional configuration. Colloid was significantly reduced in amount and fragmented in ThinPrep, and was easily observed in SurePath. In cases of Hashimoto's thyroiditis, ThinPrep produced much less leukocytes in background than SurePath. Aggregates of fibrin and leukocytes were frequently present in 10/16 cases (62.5%) processed by ThinPrep. Air-dry artifact at periphery of the ring was present in 6/16 cases (37.5%) processed by ThinPrep. The nuclear features of papillary carcinoma were similarly evident in both LBC preparations. CONCLUSION SurePath seems to be superior to ThinPrep for diagnosing benign entities based on adequate representation of colloid and lymphocytes. The cell quality of both techniques in thyroid FNA was comparable, while each method introduces its own unique cytologic artifacts related to its methodology. We should recognize the cytomorphologic alterations to avoid misinterpretations.
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Affiliation(s)
- Wen-Ying Lee
- Division of Cytopathology, Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan
| | - Hsiu-Chu Wang
- Division of Cytopathology, Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan
| | - Kai-Jen Tien
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
- Renxin Clinics, Tainan, Taiwan
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Ikeda K, Sakabe N, Maruyama S, Ito C, Shimoyama Y, Oboshi W, Komene T, Yamaguchi Y, Sato S, Nagata K. Relationship between a deep learning model and liquid-based cytological processing techniques. Cytopathology 2023; 34:308-317. [PMID: 37051774 DOI: 10.1111/cyt.13235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/28/2023] [Accepted: 03/23/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE Artificial intelligence (AI)-based cytopathology studies conducted using deep learning have enabled cell detection and classification. Liquid-based cytology (LBC) has facilitated the standardisation of specimen preparation; however, cytomorphology varies according to the LBC processing technique used. In this study, we elucidated the relationship between two LBC techniques and cell detection and classification using a deep learning model. METHODS Cytological specimens were prepared using the ThinPrep and SurePath methods. The accuracy of cell detection and cell classification was examined using the one- and five-cell models, which were trained with one and five cell types, respectively. RESULTS When the same LBC processing techniques were used for the training and detection preparations, the cell detection and classification rates were high. The model trained on ThinPrep preparations was more accurate than that trained on SurePath. When the preparation types used for training and detection were different, the accuracy of cell detection and classification was significantly reduced (P < 0.01). The model trained on both ThinPrep and SurePath preparations exhibited slightly reduced cell detection and classification rates but was highly accurate. CONCLUSIONS For the two LBC processing techniques, cytomorphology varied according to cell type; this difference affects the accuracy of cell detection and classification by deep learning. Therefore, for highly accurate cell detection and classification using AI, the same processing technique must be used for both training and detection. Our assessment also suggests that a deep learning model should be constructed using specimens prepared via a variety of processing techniques to construct a globally applicable AI model.
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Affiliation(s)
- Katsuhide Ikeda
- Pathophysiology Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nanako Sakabe
- Pathophysiology Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sayumi Maruyama
- Pathophysiology Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chihiro Ito
- Pathophysiology Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuka Shimoyama
- Pathophysiology Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Wataru Oboshi
- Department of Medical Technology and Sciences, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | - Tetsuya Komene
- Department of Medical Technology and Sciences, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | - Yoshitaka Yamaguchi
- Department of Medical Technology and Sciences, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | - Shouichi Sato
- Clinical Engineering, Faculty of medical sciences, Juntendo University, Urayasu, Japan
| | - Kohzo Nagata
- Pathophysiology Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Baykus N, Özekinci S, Erdem ZB, Vurgun E, Yildiz FR. Comparison of Morphological Similarities and Differences between Liquid-Based Cytology and Conventional Techniques of Serous Effusion Cytology Specimens. Acta Cytol 2021; 66:159-164. [PMID: 34969029 DOI: 10.1159/000521052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/14/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study is to discover a fast and efficient method for the diagnosis of serous effusion cytology specimens by comparing the cytomorphological features of SurePath (SP) smears and smears prepared by cytospin. After the macroscopic features of the incoming material were recorded, it was divided into 2 for conventional technique (CT) and liquid-based technique. Cytospin was used for CT and SurePath for liquid-based technique in this study. MATERIALS AND METHODS 243 serous effusions (33 thoracentesis and 92 paracentesis fluids, 118 peritoneal lavage fluids) were investigated. After shaking the effusion gently, it was centrifuged for 5 min at 1,250 rpm for cytospin smear. SP smear was prepared according to the "BD PrepStain slide processor". Two smears were prepared with these 2 methods and then stained with Papanicolaou. The smears were examined under a light microscope in terms of fixation, background, cellularity, nucleus, and structural features. All statistical analysis of the data was performed using the SPSS 17.0 software. For each microscopic feature, the χ2 test was used to assess the significance of the relationship between cytospin and SP, and level of agreement in between the methods was assessed using the kappa statistic. RESULTS A statistically significant difference was observed between the 2 methods in background (p < 0.001), cellularity (p < 0.001), nucleus features (p < 0.001), and structural features (p < 0.05). There was no significant difference in fixation. Low level of agreement was observed with the kappa statistic in fixation, background, and cellularity. Moderate level of agreement was observed in the nucleus and structural feature groups with the kappa statistic. DISCUSSION/CONCLUSION Although there are advantages of liquid-based technique such as standardized fixation and cleaner background, since the cellular and background components required for morphological analysis and diagnosis are better preserved in cytospin, it is considered to be better to use liquid-based technique not alone but together with CT.
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Affiliation(s)
- Nurhan Baykus
- Department of Pathology, Kirklareli Training and Research Hospital, Kirklareli, Turkey
| | - Selver Özekinci
- Department of Pathology, Dicle University Medical School, Diyarbakir, Turkey
| | - Zeynep Betul Erdem
- Department of Pathology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Eren Vurgun
- Department of Biochemistry, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
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Ikeda K, Oboshi W, Hashimoto Y, Komene T, Yamaguchi Y, Sato S, Maruyama S, Furukawa N, Sakabe N, Nagata K. Characterizing the Effect of Processing Technique and Solution Type on Cytomorphology Using Liquid-Based Cytology. Acta Cytol 2021; 66:55-60. [PMID: 34644702 DOI: 10.1159/000519335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/31/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Liquid-based cytology (LBC) is increasingly used for nongynecologic applications. However, the cytological preparation of LBC specimens is influenced by the processing technique and the preservative used. In this study, the influence of the processing techniques and preservatives on cell morphology was examined mathematically and statistically. METHODS Cytological specimens were prepared using the ThinPrep (TP), SurePath (SP), and AutoSmear methods, with 5 different preservative solutions. The cytoplasmic and nuclear areas of Papanicolaou-stained specimens were measured for all samples. RESULTS The cytoplasmic and nuclear areas were smaller in cells prepared using the 2 LBC methods, compared to that prepared using the AutoSmear method, irrespective of the preservative used. The cytoplasmic and nuclear areas of cells prepared using the SP method were smaller than those of cells prepared using the TP method, irrespective of the preservative used. There were fewer differences among the cytoplasmic areas of cells prepared with different preservative solutions using the TP method; however, the cytoplasmic areas of cells prepared using the SP method changed with the preservative solution used. CONCLUSIONS The most significant difference affecting the cytoplasmic and nuclear areas was the processing technique. The TP method increased the cytoplasmic and nuclear areas, while the methanol-based PreservCyt solution enabled the highest enlargement of the cell. LBC is a superior preparation technique for standardization of the specimens. Our results offer a better understanding of methods suitable for specimen preparation for developing precision AI-based diagnosis in cytology.
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Affiliation(s)
- Katsuhide Ikeda
- Pathophysiology Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Wataru Oboshi
- Department of Medical Technology and Sciences, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | - Yusuke Hashimoto
- Department of Medical Technology and Sciences, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | - Tetsuya Komene
- Department of Medical Technology and Sciences, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | - Yoshitaka Yamaguchi
- Department of Medical Technology and Sciences, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | - Shouichi Sato
- Department of Medical Technology and Sciences, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | - Sayumi Maruyama
- Pathophysiology Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nozomi Furukawa
- Pathophysiology Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nanako Sakabe
- Pathophysiology Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kohzo Nagata
- Pathophysiology Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Okuda C, Kyotake A, Nakamura A, Itoh T, Kamoshida S, Ohsaki H. Quantitative cytomorphological comparison of SurePath and ThinPrep liquid-based cytology using high-grade urothelial carcinoma cells. Cytopathology 2021; 32:654-659. [PMID: 34033150 DOI: 10.1111/cyt.12998] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/16/2021] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE In The Paris System for Reporting Urinary Cytology (TPS), the important cytomorphological features for diagnosing high-grade urothelial carcinoma (HGUC) are a nuclear-to-cytoplasmic (N:C) ratio exceeding 0.7, hyperchromasia, coarse chromatin, and irregular nuclear borders. However, quantitative cytomorphological assessments of HGUC cells using SurePath slides are rare. Therefore, we evaluated HGUC cells on SurePath slides quantitatively using a digital image analysis system and compared these data with ThinPrep data. METHODS The same urine samples were divided into two aliquots and used to prepare SurePath and ThinPrep slides. We used ImageJ to measure the N:C ratio, hyperchromasia, and irregular nuclear borders for HGUC cells on SurePath and ThinPrep slides. RESULTS The total number of analysed HGUC cells on SurePath slides was 981, versus 889 on ThinPrep slides. Hyperchromasia and irregular nuclear borders were significantly more severe on SurePath than on ThinPrep slides. Conversely, the N:C ratio did not differ between the methods. Additionally, HGUC cells with N:C ratios exceeding 0.7 were present on almost all slides for both methods. CONCLUSIONS Our data indicated the reasonableness of using the N:C ratio as the major criterion for TPS on both SurePath and ThinPrep slides, and an N:C ratio cut-off of 0.7 as suitable for identifying HGUC cells. However, the severity of hyperchromasia and irregular nuclear borders differed between the processing methods.
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Affiliation(s)
- Chihiro Okuda
- Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Aiko Kyotake
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akihiro Nakamura
- Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shingo Kamoshida
- Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Hiroyuki Ohsaki
- Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Badyal RK, Sandhu VK. Tubercular granulomas in Bronchoalveolar lavage fluid in SurePath liquid-based cytology smears: An enigmatic finding. Lung India 2021; 38:295-296. [PMID: 33942764 PMCID: PMC8194427 DOI: 10.4103/lungindia.lungindia_604_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Rama Kumari Badyal
- Department of Pathology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Vaneet Kaur Sandhu
- Department of Pathology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
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Budhwar A, Kataria SP, Kumar S, Singh G, Kaushik N, Sen R. Fine needle aspiration cytology of cervical lymph nodes: Comparison of liquid based cytology (SurePath) and conventional preparation. Diagn Cytopathol 2020; 49:18-24. [PMID: 32841545 DOI: 10.1002/dc.24589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 07/03/2020] [Accepted: 08/03/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Fine needle aspiration cytology (FNAC) is the first diagnostic step in patient with cervical lymphadenopathy because of its simplicity, safety and early availability of the results. Liquid-based cytology (LBC) is an alternative processing method which is used for both gynecological and nongynecological samples. Literature reviewed show few studies comparing LBC with conventional preparation (CP). AIM The present study was undertaken to evaluate the efficacy of LBC and comparison of LBC and CP in cervical lymphadenopathy. MATERIALS AND METHODS In this prospective study, a total of 75 cases of FNAC with cervical lymphadenopathy were included. The first pass was used for CP followed by LBC with the use of SurePath (SP) technique. Both the smears were compared for cellularity, background containing blood, cell debris, lymphoglandular bodies, stromal fragments, cytoarchitectural pattern, etc., by semiquantitative scoring system. RESULTS There was no statistical difference in the cellularity, cell architecture, and monolayer cells (P > .05). On the basis of background containing blood, cell debris, lympho-glandular bodies, stromal fragments (P < .001), nuclear, and cytoplasmic details (P < .05), LBC was found to be superior to CP. CONCLUSION LBC is a relatively simple technique and superior to CP in respect of better nuclear and cytoplasmic details with loss of background blood and debris. It has a diagnostic accuracy equivalent to that of CP. However, use of both LBC and CP can result in better diagnostic accuracy.
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Affiliation(s)
- Archana Budhwar
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Sant Prakash Kataria
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Sanjay Kumar
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Gajender Singh
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Nidhi Kaushik
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Rajeev Sen
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
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Kim L, Choi S, Park I, Han J, Kim J, Chu Y. Cytomorphologic features of small cell carcinoma of lung in effusion fluid using a liquid‐based cytology technique. Diagn Cytopathol 2019; 48:203-210. [DOI: 10.1002/dc.24365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 11/06/2019] [Accepted: 11/27/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Lucia Kim
- Department of PathologyInha University College of Medicine, Inha University Hospital Incheon South Korea
| | - Suk‐Jin Choi
- Department of PathologyInha University College of Medicine, Inha University Hospital Incheon South Korea
| | - In‐Suh Park
- Department of PathologyInha University College of Medicine, Inha University Hospital Incheon South Korea
| | - Jee‐Young Han
- Department of PathologyInha University College of Medicine, Inha University Hospital Incheon South Korea
| | - Joon‐Mee Kim
- Department of PathologyInha University College of Medicine, Inha University Hospital Incheon South Korea
| | - Young‐Chae Chu
- Department of PathologyInha University College of Medicine, Inha University Hospital Incheon South Korea
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Norimatsu Y, Yanoh K, Hirai Y, Kurokawa T, Kobayashi TK, Fulciniti F. A Diagnostic Approach to Endometrial Cytology by Means of Liquid-Based Preparations. Acta Cytol 2019; 64:195-207. [PMID: 31473735 DOI: 10.1159/000502108] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/15/2019] [Indexed: 12/12/2022]
Abstract
The adoption of endometrial cytology as a diagnostic procedure has been hampered in the past by difficulties arising in interpreting the cellular findings due to a number of factors (such as excess blood, cellular overlapping, and the complex physiology of endometrium). Recently, the use of liquid-based cytology (LBC), with its ability to remove blood and mucus and to distribute cells uniformly in a thin layer on the slide, has provided an opportunity to reevaluate the role of endometrial cytology. LBC samples are easier to screen compared to conventional ones, due to a smaller screening area and an excellent quality of cell preparations. LBC by using peculiar cytoarchitectural features is a useful tool in the cellular diagnosis and follow-up of abnormalities, which, however, remains complementary to histopathology and to the emerging molecular diagnostic cytopathology. This review discusses these various entities and takes into consideration the ancillary techniques that may be useful in the diagnostic procedure. Herein, we also summarize the process and rationale by which updates were made to the standardized terminology in 2018 and outline the contents of the new Bethesda-style classification (the Yokohama system) for the endometrial cytology.
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Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Japan,
| | - Kenji Yanoh
- Department of Obstetrics and Gynecology, JA Suzuka General Hospital, Suzuka, Japan
| | - Yasuo Hirai
- Department Obstetrics and Gynecology, Faculty of Medicine, Dokkyo Medical University, Mibumachi, Japan
- Department of Cytology, PCL Japan Pathology and Cytology Center, PCL Inc., Kawagoe, Japan
| | - Tetsuji Kurokawa
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tadao K Kobayashi
- Cancer Education and Research Center, Osaka University Graduate School of Medicine, Suita, Japan
| | - Franco Fulciniti
- Clinical Cytopathology Service, Istituto Cantonale di Patologia, Locarno, Switzerland
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Toyonaga Y, Yamazaki K, Koyama Y, Yamada M, Ishida Y. A Modified Direct-Smear Processing Technique Employing Two-Step Centrifugation/Fixation Is Useful for Detecting High-Grade Urothelial Carcinoma. Acta Cytol 2017; 61:447-454. [PMID: 28954257 DOI: 10.1159/000480062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 08/08/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To demonstrate the usefulness of a direct-smear processing technique employing two-step centrifugation/fixation processing (TSCFP) in the cytoscreening of high-grade urothelial carcinoma (HGUC). STUDY DESIGN Using the T24 HGUC cell line, we compared the cell yield and the morphological preservation of preparations concurrently processed by direct-smear, SurePath, ThinPrep, and TSCFP techniques. A total of 287 urine cytology cases subjected to TSCFP over a period of 6 years were reviewed and reclassified according to the Paris System for Reporting Urinary Cytology (PSRUC) and correlated with histology results. RESULTS TSCFP of T24 cells demonstrated good cell yield with a recovery rate of about 70%. Diagnostic features of HGUC, such as a high nuclear/cytoplasmic ratio and irregular/hyperchromatic chromatin, were better discovered in TSCFP smears than in smears prepared with the other methods. Cytological evaluation of 287 voided urine specimens revealed that the rate of unsatisfactory preparations was quite low (0.30%) and the overall sensitivity, specificity, and positive and negative predictive values for urothelial carcinoma were 0.719, 0.923, 0.973, and 0.462, respectively. CONCLUSION TSCFP was able to provide adequate preparations for detecting HGUC in urine cytology and could be considered as a promising processing method according to the principal purpose of PSRUC.
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Affiliation(s)
- Yasuhiro Toyonaga
- Department of Surgical Pathology, Teikyo University, Chiba Medical Center, Ichihara, Japan
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Kwon H, Kim WG, Eszlinger M, Paschke R, Song DE, Kim M, Park S, Jeon MJ, Kim TY, Shong YK, Kim WB. Molecular Diagnosis Using Residual Liquid-Based Cytology Materials for Patients with Nondiagnostic or Indeterminate Thyroid Nodules. Endocrinol Metab (Seoul) 2016; 31:586-591. [PMID: 27834083 PMCID: PMC5195836 DOI: 10.3803/enm.2016.31.4.586] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/20/2016] [Accepted: 09/22/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Molecular analysis for common somatic mutations in thyroid cancer can improve diagnostic accuracy of fine-needle aspiration cytology (FNAC) in the nondiagnostic or indeterminate category of thyroid nodules. In this study, we evaluated the feasibility of molecular diagnosis from residual liquid-based cytology (LBC) material after cytological diagnosis. METHODS This prospective study enrolled 53 patients with thyroid nodules diagnosed as nondiagnostic, atypia of undetermined significance (AUS), or follicular lesion of undetermined significance (FLUS) after FNAC. DNAs and RNAs were isolated from residual LBC materials. BRAF(V600E) and RAS point mutations, PAX8/peroxisome proliferator-activated receptor γ (PPARγ), RET/PTC1, and RET/PTC3 rearrangements were evaluated by real-time polymerase chain reaction and pyrosequencing. RESULTS All DNAs from 53 residual LBC samples could be analysed and point mutations were detected in 10 samples (19%). In 17 AUS nodules, seven samples (41%) had point mutations including BRAF (n=4), NRAS (n=2), and KRAS (n=1). In 20 FLUS nodules, three samples (15%) had NRAS point mutations. RNA from only one FLUS nodule could be analysed for rearrangements and there was no abnormality. CONCLUSION Molecular analysis for BRAF and RAS mutations was feasible in residual LBC materials and might be useful for diagnosis of indeterminate thyroid nodules.
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Affiliation(s)
- Hyemi Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Markus Eszlinger
- Division of Endocrinology and Metabolism, Department of Oncology and Arnie Charbonneau Cancer Institute, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ralf Paschke
- Division of Endocrinology and Metabolism, Department of Oncology and Arnie Charbonneau Cancer Institute, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Dong Eun Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mijin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suyeon Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ji Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Yong Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Kee Shong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Bae Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Lee CH, Chung SY, Moon KC, Park IA, Chung YR, Ryu HS. A Pilot Study Evaluating Fine-Needle Aspiration Cytology of Clear-Cell Renal Cell Carcinoma: Comparison of Ancillary Immunocytochemistry and Cytomorphological Characteristics of SurePath™ Liquid-Based Preparations with Conventional Smears. Acta Cytol 2015; 59:239-47. [PMID: 26044824 DOI: 10.1159/000430081] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 04/10/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Fine-needle aspiration cytology (FNAC) based on a liquid-based preparation is a safe and valuable diagnostic tool. However, due to unfamiliarity with this method and the considerably altered morphology that is associated with it, diagnosing renal cell carcinoma (RCC) from this type of preparation remains a challenge for cytopathologists. The aim of this study was to evaluate the cytomorphological characteristics of SurePath™ (SP)-based preparations compared with conventional smear (CS), and also the role of SP-based FNAC in the diagnosis of clear-cell RCC (CRCC), the most common primary renal malignancy. STUDY DESIGN Ex vivo FNAC of both tumors and normal renal parenchyma was prepared from 73 cases. Comparative cytomorphological analysis between liquid-based cytology (LBC) and CS as well as Fuhrman nuclear grading (FNG) was carried out. Immunocytochemistry was performed from normal and CRCC cytology specimens. RESULTS Normal renal cytology (NRC) showed no significant morphological differences between LBC and CS. For CRCC, LBC showed small, fragmented cell clusters, a 3-dimensional configuration, distinct cytoplasmic vacuoles, and irregular nuclear contours when compared with CS. FNG was overgraded with LBC compared to with CS. AMACR was the most valuable immunocytochemical marker for distinguishing CRCC from NRC. CONCLUSION Once cytopathologists become familiar with the altered cytomorphological features of CRCC, FNAC, along with immunocytochemistry, may prove helpful for diagnosis.
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Affiliation(s)
- Chung Hun Lee
- Department of Pathology, The Armed Forces Capital Hospital, Seongnam, South Korea
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Pan Z, Yang G, Wang Y, He H, Pang X, Gao Y, Shi W, Li Y, Dong L, Song Y. Thinprep plus Papanicolaou stain method is more sensitive than cytospin-coupled Wright Giems stain method in cerebrospinal fluid cytology for diagnosis of leptomeningeal metastasis from solid tumors. PLoS One 2015; 10:e0122016. [PMID: 25850010 PMCID: PMC4388538 DOI: 10.1371/journal.pone.0122016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 02/05/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The present study was designed to determine whether the Thinprep plus Papanicolaou stain (Thinprep) method is more sensitive than the Cytospin-coupled Wright-Giemsa (WG) stain (Cytospin) method in diagnosis of leptomeningeal metastasis (LM) from malignant solid tumors in cerebrospinal fluid (CSF). We also explored if the Thinprep method could be used in the differential diagnosis of the type of primary tumor cells based on the morphology of tumor cells in CSF samples. METHODS The morphological features of tumor cells in fresh CSF samples were analyzed using both methods. The tumor cell detection rates were compared between the two methods. RESULTS Using the Thinprep method, we found that each type of tumor cells in the CSF samples had specific identifiable morphological features linked to their primary cancer origins, such as adenocarcinomas originated from the lungs, breast, and stomach, and lung squamous cell carcinomas, small cell lung cancer, large-cell neuroendocrine lung cancer, hepatocellular carcinoma, and malignant melanoma. In a retrospective study with 88 LM patients, cancer cells were detected in 80 out of the 88 CSF samples. In the comparative study with 45 LM patients, the initial detection rate of the Thinprep method was significantly higher than that of the Cytospin method (73.3% vs. 57.8%, P<0.01). The cell morphology was better preserved and subcellular structures were clearer using the Thinprep method, compared to the Cytospin method. CONCLUSIONS The Thinprep method is more sensitive and suitable for LM diagnosis in CSF in patients with malignant solid tumors than the Cytospin method. The Thinprep method may facilitate primary tumor detection and help design early treatment regimens for LM patients with tumors of unknown primary origin.
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Affiliation(s)
- Zhenyu Pan
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
| | - Guozi Yang
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
| | - Yongxiang Wang
- Department of Clinical Laboratory, the First Hospital, Jilin University, Changchun, China
| | - Hua He
- Cancer Center, the First Hospital, Jilin University, Changchun, China
| | - Xiaochuan Pang
- Department of Clinical Laboratory, the First Hospital, Jilin University, Changchun, China
| | - Yan Gao
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
| | - Weiyan Shi
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
| | - Yu Li
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
| | - Lihua Dong
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
- * E-mail: (LD); (YS)
| | - Yuanyuan Song
- Department of Clinical Laboratory, the First Hospital, Jilin University, Changchun, China
- * E-mail: (LD); (YS)
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Ren S, Solomides C, Draganova-Tacheva R, Bibbo M. Overview of nongynecological samples prepared with liquid-based cytology medium. Acta Cytol 2014; 58:522-32. [PMID: 25115150 DOI: 10.1159/000363123] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 04/22/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Liquid-based cytology of nongynecological specimens is commonly used in cytology laboratories throughout the world and various processing methods, such as ThinPrep and SurePath, have been reported. The cytological features and performance of liquid-based cytology for various cytology specimens, including body cavity fluids, urine, brushing specimens and fine-needle aspiration of various lesions, were reviewed and compared with the experience of our laboratory and the literature published in PubMed. STUDY DESIGN The parameters for the evaluation of liquid-based cytology and conventional smears were described in the various types of specimens. Criteria for the interpretation of nongynecological liquid-based cytology were highlighted to show differences in cell morphology, background and artifacts. RESULTS The interpretation requires familiarity with the appearance of liquid-based cytology in the various types of preparations to avoid misdiagnosis. CONCLUSIONS Cell blocks can be prepared with specimens preserved in a liquid-based cytology medium and immunocytochemical stains and molecular testing can be successfully performed. These are important adjuncts in order to reach a definitive diagnosis.
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Affiliation(s)
- Shuyue Ren
- Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, Pa., USA
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15
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Pouliakis A, Margari C, Margari N, Chrelias C, Zygouris D, Meristoudis C, Panayiotides I, Karakitsos P. Using classification and regression trees, liquid-based cytology and nuclear morphometry for the discrimination of endometrial lesions. Diagn Cytopathol 2013; 42:582-91. [DOI: 10.1002/dc.23077] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 10/29/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Abraham Pouliakis
- Department of Cytopathology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | | | - Niki Margari
- Department of Cytopathology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | - Charalampos Chrelias
- 3rd Department of Obstetrics and Gynecology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | - Dimitrios Zygouris
- 3rd Department of Obstetrics and Gynecology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | - Christos Meristoudis
- Department of Cytopathology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology; University of Athens; “ATTIKON” University Hospital; Athens Greece
| | - Petros Karakitsos
- Department of Cytopathology; University of Athens; “ATTIKON” University Hospital; Athens Greece
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Zendehrokh N, Olejnicka B, Westman A, Dejmek A. Liquid-based cytology using cytorich Red/Tripath is diagnostically equivalent to conventional smears for bronchial washings and brushings and reduces the cost. Diagn Cytopathol 2013; 41:876-84. [DOI: 10.1002/dc.22981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/08/2012] [Accepted: 02/07/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Nooreldin Zendehrokh
- University and Regional Laboratories, Region Skåne; Clinical Pathology, SUS Malmö; Sweden
| | | | - Agneta Westman
- University and Regional Laboratories, Region Skåne; Clinical Pathology, SUS Malmö; Sweden
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Norimatsu Y, Yanoh K, Kobayashi TK. The role of liquid-based preparation in the evaluation of endometrial cytology. Acta Cytol 2013; 57:423-35. [PMID: 24021666 DOI: 10.1159/000353148] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 05/09/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Liquid-based preparation (LBP) of the endometrial lesions is an important diagnostic tool for a variety of endometrial abnormalities because of its simplicity and high quali-quantitative diagnostic yield. We aimed to investigate the LBP method for endometrial cytology to evaluate both benign and abnormal endometrial lesions. STUDY DESIGN LBP is a semiautomated methodology that has recently become widely available and has gained popularity as a method of collecting and processing both gynecologic and nongynecologic cellular specimens. RESULTS Some peculiar endometrial cytoarchitectural features were described using LBPs. These were advantageous to screen as compared to conventional slides due to a smaller screening area and an excellent quality of cell preparations. CONCLUSIONS LBP is a useful tool in the cellular diagnosis and follow-up of endometrial abnormalities, which remains complementary to the emerging molecular diagnostic cytopathology. The study of LBPs from endometrial cytology could be challenging since it is affected by numerous look-alikes and diagnostic pitfalls. This review discusses these various entities and takes into consideration the ancillary techniques that may be useful in the diagnostic procedure.
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Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Tobe, Japan
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18
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Ryu HS, Park IA, Park SY, Jung YY, Park SH, Shin HC. A pilot study evaluating liquid-based fine needle aspiration cytology of breast lesions: a cytomorphological comparison of SurePath® liquid-based preparations and conventional smears. Acta Cytol 2013; 57:391-9. [PMID: 23860283 DOI: 10.1159/000351306] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 04/11/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Fine needle aspiration cytology (FNAC) is recommended by the World Health Organization as a diagnostic method for breast lesions. The morphological interpretation of liquid-based preparations (LBPs) remains a diagnostic challenge due to considerably altered cytomorphology. The aim of the current study was to compare cytomorphological characteristics of SurePath® (SP)-based LBP and conventional smear (CS) in breast FNACs. STUDY DESIGN The study included 77 benign and 60 malignant breast FNACs obtained by both SP and CS, all with tissue confirmation. Cases analyzed with both preparations were reviewed and compared, focusing on 10 cytomorphological features. RESULTS SP aspirates demonstrated notable cytomorphological alterations. Among them, a prominent three-dimensional configuration of cell clusters and frequent and conspicuous nucleoli were the most prominent characteristics of SP compared with CS. Overall diagnostic performances were comparable but were slightly lower for SP than CS (diagnostic accuracy of two reviewers; 87.6 and 90.5% for SP vs. 91.2 and 92.7% for CS, respectively). CONCLUSION Although the reviewer should be aware of distinctive cytomorphological alterations, the SP technique is reliable for the evaluation of breast lesions with the advantage of easy interpretation and a diagnostic accuracy equivalent to CS.
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Affiliation(s)
- Han Suk Ryu
- Department of Pathology, Seoul National University Hospital, Seoul, South Korea.
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Giannakopoulos T, Moulakakis K, Sfyroeras G, Avgerinos E, Antonopoulos C, Kakisis J, Karakitsos P, Brountzos E, Liapis C. Association between Plaque Echogenicity and Embolic Material Captured in Filter during Protected Carotid Angioplasty and Stenting. Eur J Vasc Endovasc Surg 2012; 43:627-31. [DOI: 10.1016/j.ejvs.2012.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Accepted: 03/05/2012] [Indexed: 11/15/2022]
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20
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Hoda RS, Loukeris K, Abdul-Karim FW. Gynecologic cytology on conventional and liquid-based preparations: a comprehensive review of similarities and differences. Diagn Cytopathol 2012; 41:257-78. [PMID: 22508662 DOI: 10.1002/dc.22842] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 01/10/2012] [Indexed: 02/06/2023]
Abstract
Liquid-based preparations (LBPs) have largely replaced conventional Papanicolaou smears (CPS) for cervical samples in the United States and in many other industrialized countries. The two FDA-approved LBP currently in use include ThinPrep (TP), (Hologic Inc., Bedford, MA) and SurePath (SP), (BD Diagnostic, Burlington, NC). Split-sample and direct-to-vial studies have shown that LBPs show an overall improvement in sample collection and processing, reduce artifacts that interfere in diagnosis, are more sensitive, can be utilized for ancillary tests and are a cost-effective replacement for CPS. Comparative analyses of diagnostic accuracy indicate that LBPs perform at least as well as CPS. However, the added advantages of standardized, automated preparations and screening, reduced unsatisfactory rate, improved specimen adequacy and ability to perform human papillomavirus (HPV) test, are enough to continue use of LBP. The cytologic features in LBP are similar to CPS with subtle differences, particularly in background information. There are also subtle differences between the two LBPs, SP and TP, which are reflective of different sampling devices, collection media, and processing techniques. Architecturally, LBP shows smaller cell clusters and sheets and more dyscohesion. Cytologically, enhanced nuclear features and smaller cell size are more prominent. Advances in liquid-based Papanicolaou's (Pap) test have lead to well-defined patient management guidelines by the American Society for Colposcopy and Cervical Pathology. Herein, we review these aspects of Pap test including, morphology, automation, ancillary tests (HPV and immunochemistry), pertinent QA/QC monitors, patient management guidelines, and review of pertinent literature.
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Affiliation(s)
- Rana S Hoda
- Department of Pathology & Laboratory Medicine, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York 10065, USA.
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Abstract
Although endoscopic ultrasonography (EUS) is considered superior to MRI and CT in detecting pancreatic masses, it is the ability to target and place a needle into suspicious lesions that has made EUS indispensible in the evaluation of patients with solid pancreatic tumors. Endoscopic ultrasound-guided-fine-needle aspiration (EUS-FNA) is an accurate and safe technique to confirm the diagnosis of pancreatic cancer. EUS-FNA is now the principal technique applied to obtain the diagnosis of malignancy. We have designed this article to address a number of the key technical aspects of EUS-FNA of solid pancreatic masses.
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Affiliation(s)
- Muhammad K Hasan
- Center for Interventional Endoscopy, Florida Hospital Orlando, 601 East Rollins Street, Orlando, FL 32803, USA
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22
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Chae SW, Kim SH, Park HD, Park WS, Cho YH, Kang SH, Kim DH, Sohn JH. Comparison of Liquid-based (SurePath™ and Conventional Preparations in Thyroid Fine Needle Aspiration. KOREAN JOURNAL OF PATHOLOGY 2010. [DOI: 10.4132/koreanjpathol.2010.44.6.651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Seoung Wan Chae
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Hee Kim
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Dae Park
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woon Sun Park
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Hye Cho
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Hee Kang
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Hoon Kim
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Hee Sohn
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim S, Owens CL. Analysis of ThinPrep cytology in establishing the diagnosis of small cell carcinoma of lung. Cancer Cytopathol 2009; 117:51-6. [DOI: 10.1002/cncy.20007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Park ES, Cho EY, Do IG, Kim SJ, Shin JH, Han BK, Oh YL. Comparison of Liqui-PREP™ and Conventional Preparations in Thyroid Fine Needle Aspiration. KOREAN JOURNAL OF PATHOLOGY 2009. [DOI: 10.4132/koreanjpathol.2009.43.6.550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Eun Su Park
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Yoon Cho
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In Gu Do
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soon Jae Kim
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Hee Shin
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Boo Kyung Han
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Lyun Oh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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25
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Hwang EC, Park SH, Jung SI, Kwon DD, Park K, Ryu SB, Park CS. Usefulness of liquid-based preparation in urine cytology. Int J Urol 2007; 14:626-9. [PMID: 17645607 DOI: 10.1111/j.1442-2042.2006.01731.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE ThinPrep (TP), a liquid-based cytological and non-invasive technique to confirm the diagnosis of bladder cancer, is reported to be a better screening test than the conventional cytospin method. This study compared the new MonoPrep2 (MP), a liquid-based cytological technique, with TP for diagnosing bladder cancer. MATERIALS AND METHODS Between January 2003 and June 2004, urine samples from 284 patients were processed using the TP and MP methods. The cytological diagnosis and the determination of specimen quality were performed separately. The cytological diagnoses were classified into four categories: unsatisfactory, benign, borderline, and malignant. A subsequent biopsy was performed in 73 patients. The cytological diagnoses were compared with the biopsy results to evaluate the sensitivity and specificity of the two methods. RESULTS Considering all the features examined, the overall specimen quality was comparable between the MP and TP techniques in the majority of cases. The rate of satisfactory specimens was 100% for TP and 98.6% for MP. The diagnostic capacity was similar between MP and TP. The overall sensitivities with MP and TP were 58.6 and 62.0%, respectively, and the specificities were 100 and 97.7%; the differences were not significant (P > 0.05). CONCLUSIONS MP and TP produced comparable results in diagnosing bladder cancer. As MP is less expensive than TP, we recommend MP as an alternative liquid-based cytology method for use in bladder cancer screening.
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Affiliation(s)
- Eu Chang Hwang
- Department of Urology, Chonnam National University, Medical School, 8 Hakdong, Donggu, Gwangju 501-757, Korea
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Hoda RS. Non-gynecologic cytology on liquid-based preparations: A morphologic review of facts and artifacts. Diagn Cytopathol 2007; 35:621-34. [PMID: 17854077 DOI: 10.1002/dc.20698] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Liquid-based preparations (LBP) are increasingly being used both for gynecologic (gyn) and non-gynecologic (non-gyn) cytology including fine needle aspirations (FNA). The two FDA-approved LBP currently in use include ThinPrep (TP), (Cytyc Corp, Marlborough, MA) and SurePath (SP), (TriPath Imaging Inc., Burlington, NC). TP was approved for cervico-vaginal (Pap test) cytology in 1996 and SP in 1999 and both have since also been used for non-gyn cytology. In the LBP, instead of being smeared, cells are rinsed into a liquid preservative collection medium and processed on automated devices. Even after a decade of use, the morphological interpretation of LBP remains a diagnostic challenge because of somewhat altered morphology and artifacts or facts resulting from the fixation and processing techniques. These changes include cleaner background with altered or reduced background and extracellular elements; architectural changes such as smaller cell clusters and sheets, breakage of papillae; altered cell distribution with more dyscohesion and changes in cellular morphology with enhanced nuclear features, smaller cell size and slightly more three-dimensional (3-D) clusters. Herein, we review the published literature on morphological aspects of LBP for non-gyn cytology.
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Affiliation(s)
- Rana S Hoda
- Department of Pathology, Cytopathology Unit, University of Rochester, Rochester, New York, USA.
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Elsheikh TM, Kirkpatrick JL, Wu HH. Comparison of ThinPrep and cytospin preparations in the evaluation of exfoliative cytology specimens. Cancer 2006; 108:144-9. [PMID: 16550571 DOI: 10.1002/cncr.21841] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND There exists limited literature comparing ThinPrep (TP) with conventional cytospins (CS) in nongynecologic specimens. METHODS The differences between TP and CS were evaluated for a variety of parameters including cellularity, cytologic morphology, specimen preparation, screening time, laboratory cost effectiveness, cytologist preference, and impact on final diagnosis. Eighty-eight cases including 38 urine, 13 respiratory, and 37 body fluids were prepared simultaneously. RESULTS TP and CS demonstrated similar cellular yield in the majority of cases. Cytologists preferred TP in 63 (71.6%) and CS in 6 (6.8%) cases; whereas they indicated no preference in 19 (21.6%) cases. Of 14 abnormal cytologies, a more definitive diagnosis of malignancy was rendered by TP in 6 (42.9%) and by CS in 2 (14.3%) cases. TP demonstrated better nuclear chromatin morphology and more uniform distribution of cells. CS showed larger-sized clusters with better preservation of their architecture compared with smaller-sized clusters and significant shrinkage of cell size in TP. CONCLUSIONS TP was preferred over CS in the majority of cases by both cytotechnologists and pathologists. Cellularity, screening time, and specimen preparation were comparable, although the latter was easier to standardize in TP. In abnormal cases, TP was found to be 3 times more helpful than CS in rendering a definitive diagnosis of malignancy. TP, however, was associated with certain artifacts that cytologists must become familiar with when examining such preparations. Although TP was superior to CS in most cases, the application of both methods may be helpful in selected cases in which the TP diagnosis is not conclusive. Finally, TP was found to be more cost effective than CS.
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Affiliation(s)
- Tarik M Elsheikh
- Pathologists Associated, Ball Memorial Hospital, Muncie, Indiana 47303, USA.
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Nam JH, Kim HS, Lee JS, Choi HS, Min KW, Park CS. A comparison of modified MonoPrep2™ of liquid-based cytology with ThinPrep® Pap test. Gynecol Oncol 2004; 94:693-8. [PMID: 15350360 DOI: 10.1016/j.ygyno.2004.05.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2004] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purpose of this study is to evaluate a modified MonoPrep2 (MP) of liquid-based cytology (LBC) to search for a less expensive alternative technique usable for screening of cervical cancers. STUDY DESIGN Cervicovaginal direct-to-vial samples from 1218 consecutive patients were processed with the modified MP technique and the results were compared with those of currently popular ThinPrep Pap test (TP) technique. RESULTS Both MP and TP methods provide uniformly spread thin layers of cells without cellular overlap or significant obscuring elements. The diameter of the circular area was 20 mm in MP and 22 mm in TP. Obscuring factors were slightly more frequent in MP but not enough to affect interpretation. Thirteen specimens were excluded from the study because of poor specimen quality in MP. In 1205 patients, there was an absolute agreement in results (the Bethesda diagnosis system) between the two methods, and discordances were observed in only 18 (1.5%) in 1187 cases (98.5%). Furthermore, there was no significant difference in diagnostic accuracy in histopathologic correlation between the two methods. The sensitivity of MP was slightly lower than that of TP, and the specificity of MP was higher than that of TP. A human papillomavirus (HPV) test with polymerase chain reaction (PCR) using broad-spectrum probes has yielded good results in both MP and TP samples. CONCLUSIONS The modification of the MP method gave comparable results to those of TP in terms of smear quality, cytologic diagnostic evaluation, and biopsy correlation with much less cost. The modified MP offers a cost-effective alternative to the currently popular expensive techniques of liquid-based cytology practical for cervical cancer screening.
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Affiliation(s)
- Jong-Hee Nam
- Department of Pathology, Chonnam National University Medical School, Gwangju, South Korea
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Yamashita A, Sakuma K, Shiina Y. Standardization of fine needle aspiration cytology of the breast -- comparison of Auto Cyto Fix and conventional smears. Cytopathology 2003; 14:79-83. [PMID: 12713480 DOI: 10.1046/j.1365-2303.2003.01097.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In Japan, there are some problems with fine needle aspiration (FNA) cytology of the breast, such as insufficient smeared cells, air-drying artefact and excessive erythrocytes. Liquid-based cytology has been found to solve these problems. Equipment for such preparations has been developed, but can be expensive to purchase and operate. We developed Auto Cyto Fix 1000 (ACF), which is inexpensive and automatically smears and fixes cells. The purpose of this study was to compare the various cytological features of conventional and ACF specimens. We evaluated whether the ACF method would be able to replace the conventional method. Forty-eight FNA specimens of breast were studied. All specimens were prepared by the direct smeared (DS) and ACF methods and evaluated for unsatisfactory cell collection, air-drying artefacts, background findings and epithelial cell findings. Although ACF specimens were prepared using the cells remaining in the needle and syringe after preparing DS specimens, the cellularity of two of the ACF specimens was better than that of the corresponding DS specimens. ACF specimens never showed air-drying artefact. Unlike DS specimens, which have many erythrocytes in the background, erythrocytes were filtered out and the background of ACF specimens was clean. We believe that many problems attributable to conventional FNA specimen preparation have been solved in this study. Preparation using the ACF apparatus can reduce running costs and can be used to prepare FNA specimens of the breast for cytological examination as an alternative to the conventional method.
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Affiliation(s)
- Akiko Yamashita
- Department of Cytology, Kyorin University School of Health Sciences, Tokyo, Japan.
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Kneafsey P, Duggan MA, McFadden S. Fine needle aspiration cytology of pulmonary, well-differentiated fetal adenocarcinoma prepared by the ThinPrep method. Cytopathology 2003; 14:87-90. [PMID: 12713482 DOI: 10.1046/j.1365-2303.2003.00031.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- P Kneafsey
- Departments of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
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