Journal of Pathology and Translational Medicine

Original Article

Morphologic Analysis of Cytomegalovirus Infected Cells in Bronchial Washing Cytology: Comparison of Liquid-Based Preparation and Conventional Smear: Jae Yeon Seok, Jungsuk An, Seung Yeon Ha, Dong Hae Chung, Sangho Lee, Hyunchul Kim; J Pathol Transl Med. 2016;50(2):147-154. Published online February 15, 2016; DOI: https://doi.org/10.4132/jptm.2015.12.25

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Background
The cytopathic effects of cytomegalovirus (CMV) infection have been well described since the virus was first reported; however, the morphology of CMV infection has not been clearly studied. We examined the difference in detailed cytologic findings in bronchial washing cytology between liquid-based and conventionally prepared smears. Methods: Bronchial washing cytology was processed using either the conventional preparation (CP) or liquid-based preparation (LBP). Sixty-nine cells with typical cytopathic effects of CMV infection were detected on CP slides and 18 cells on LBP slides. Using the image analyzer, area, circumference, major axis, and minor axis of the cytoplasm, nucleus, and intranuclear inclusion were measured in singly scattered CMV-infected cells, and histiocytes were used as a control. Results: The mean cytoplasmic area of CMV-infected cells was 1.47 times larger than that of histiocytes in CP and 2.92 times larger in LBP (p<.05). The mean nuclear area of CMV-infected cells was 2.61 times larger than that of histiocytes in CP and 4.25 times larger in LBP (p<.05). The nucleus to cytoplasm ratio and intranuclear inclusion to cytoplasm ratio of the mean area, circumference, major axis, and minor axis in CP were larger than those in LBP (p<.05). Conclusions: The sizes of cytoplasm, nucleus, and intranuclear inclusion were larger in LBP than in CP, indicating that CMV-infected cells are easily detectable in LBP. However, the nucleus-to-cytoplasm ratio was larger in CP, suggesting that differentiation from malignancy or regenerative atypia requires caution in CP.

Citations

Citations to this article as recorded by

Tissue Pathogens and Cancers: A Review of Commonly Seen Manifestations in Histo- and Cytopathology
Tzy Harn Chua, Lavisha S Punjabi, Li Yan Khor
Pathogens.2021; 10(11): 1410. CrossRef
Diagnosis of Infectious Diseases in the Lower Respiratory Tract: A Cytopathologist's Perspective
Rebecca J. Baldassarri, Deepika Kumar, Stephen Baldassarri, Guoping Cai
Archives of Pathology & Laboratory Medicine.2019; 143(6): 683. CrossRef

Brief Case Report

Lymphoepithelioma-like Carcinoma of the Renal Pelvis: A Case Report and Review of the Literature: Hyein Ahn, Jongmin Sim, Hyunsung Kim, Kijong Yi, Hulin Han, Yumin Chung, Abdul Rehman, Seung Sam Paik; Korean J Pathol. 2014;48(6):458-461. Published online December 31, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.6.458

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Citations

Citations to this article as recorded by

Analysis of genetic profiling, pathomics signature, and prognostic features of primary lymphoepithelioma‐like carcinoma of the renal pelvis
Bo Fan, Yuanbin Huang, Hongshuo Zhang, Tingyu Chen, Shenghua Tao, Xiaogang Wang, Shuang Wen, Honglong Wang, Zhe Lin, Tianqing Liu, Hongxian Zhang, Tao He, Xiancheng Li
Molecular Oncology.2022; 16(20): 3666. CrossRef
Lymphoepithelioma-like carcinoma of the upper urinary tract: A systematic review of case reports
Shi-Cong Lai, Samuel Seery, Wei Zhang, Ming Liu, Guan Zhang, Jian-Ye Wang
World Journal of Clinical Cases.2020; 8(4): 771. CrossRef
Rare primary lymphoepithelioma-like carcinoma of the renal pelvis
Shi-Cong Lai, Samuel Seery, Tong-Xiang Diao, Jian-Ye Wang, Ming Liu
World Journal of Clinical Cases.2020; 8(9): 1752. CrossRef
Eight-year follow-up of locally advanced lymphoepithelioma-like carcinoma at upper urinary tract: A case report
Che H Yang, Wei C Weng, Yi S Lin, Li H Huang, Chin H Lu, Chao Y Hsu, Yen C Ou, Min C Tung
World Journal of Clinical Cases.2020; 8(19): 4505. CrossRef
Lymphoepithelioma-like, a variant of urothelial carcinoma of the urinary bladder: a case report and systematic review for optimal treatment modality for disease-free survival
Andy W. Yang, Aydin Pooli, Subodh M. Lele, Ina W. Kim, Judson D. Davies, Chad A. LaGrange
BMC Urology.2017;[Epub] CrossRef

Original Articles

Evaluation of cytopathologic diagnosis of lung carcinoma.: In Ae Park, Eui Keun Ham; Korean J Cytopathol. 1991;2(1):20-27.

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Abstract PDF: In order to evaluate the role of cytopathologic diagnosis of sputum, bronchial washing and bronchial brushing in the diagnosis of lung cancer, we performed this study. The patients included in this study had undergone sputum, bronchial washing and brushing cytology over the 20-month period of 1985 through 1987. The total number of specimens was 5,495 of 2,242 patients, including 4,830 sputa and 665 bronchial washing and brushings. The average number of sputa and bronchial washings and brushings per case was 2.4 and 1.2 respectively. Among them, about 10% were unsatisfactory specimen, and three-fourths were negative specimens. In sputum cytology, the diagnosis of "atypical cells" was given to 3%, "suspicious for malignancy" was given to 1 %, and "malignancy" was given to 13%. In bronchial washing and brushing cytology, the diagnosis of "atypical cells", "suspicious for malignancy" and malignancy" was given to 6%, 3%, and 20% respectively. The cases diagnosed as "atypical cells" in cytology were actually malignancy in 95% and 84.8% of sputum and bronchial washing and brushings respectively, and the "suspicious for malignancy" were actually malignancy in 100% in both methods. The detection rates of malignancy were 50.4% and 55.2% in sputum and bronchial washing and brushing respectively, and the specificity was 100% in both methods. The accuracy of cell typing was 92% in sputum and 89.7% in bronchial washing and brushing.

Comparison of Conventional Smear, Cell Block and Liquid-based Preparation in the Evaluation of Bronchial Washing Specimen in Lung Cancer Patients.: Hyunee Yim, Hee Jae Joo, Young Bae Kim, Soon Won Hong; Korean J Pathol. 2011;45(3):296-302.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.296

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Abstract PDF

BACKGROUND
The preparation of conventional smears (CS) from mucoid samples, despite mucolysis, can pose difficulties for cytotechnologists or cytopathologists. In recent years, liquid-based cytology (LBC) devices have been developed in attempts to improve the cytopreparation process. LBC improves both sample collection and sample preparation. Cell block preparations (CB) can be made from residual tissue fluids, and are a useful adjunct to smears.
METHODS
We retrospectively reviewed 3 preparations from 209 patients whose diagnosis was later confirmed via bronchoscopic biopsy, fine needle aspiration, gun biopsy or operation. Each case was categorized into one of three groups: "negative," "atypical or suspicious" and "malignant." RESULTS: When conflating the "atypical" and "malignant" categories into a "positive" category, the sensitivity of each preparation was 74.4% in LBC, 72.9% in CS, and 76.5% in CB preparations. Specificity was 98.7%, 94.7% and 98.7%, respectively. By combining LBC and CB, the sensitivity is 78.2%.
CONCLUSIONS
Among three different preparation methods, sensitivity is highest in the CB method. LBC has many advantages in evaluating cell morphology and by combining CB method, the sensitivity can be improved slightly. The application of all three methods may prove helpful when one or another method proves diagnostically inconclusive.

Citations

Citations to this article as recorded by

Comparison of diagnostic accuracy between CellprepPlus® and ThinPrep® liquid‐based preparations in effusion cytology
Yong‐Moon Lee, Ji‐Yong Hwang, Seung‐Myoung Son, Song‐Yi Choi, Ho‐Chang Lee, Eun‐Joong Kim, Hye‐Suk Han, Jin young An, Joung‐Ho Han, Ok‐Jun Lee
Diagnostic Cytopathology.2014; 42(5): 384. CrossRef
Evaluation of Urine Cytology in Urothelial Carcinoma Patients: A Comparison of CellprepPlus® Liquid-Based Cytology and Conventional Smear
Seung-Myoung Son, Ji Hae Koo, Song-Yi Choi, Ho-Chang Lee, Yong-Moon Lee, Hyung Geun Song, Hae-Kyung Hwang, Hye-Suk Han, Seok-Joong Yun, Wun-Jae Kim, Eun-Joong Kim, Ok-Jun Lee
Korean Journal of Pathology.2012; 46(1): 68. CrossRef

Cytopathology of Metastatic Mucoepidermoid Carcioma of the Lung.: Weon Seo Park, Eui Keun Ham; Korean J Cytopathol. 1994;5(2):180-183.

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Abstract PDF: A case of metastatic mucoepidermoid carcinoma of the lung, originating from the hard palate, was diagnosed by sputum and bronchial washing cytology. Although the cytologic features of mucoepidermoid carcinoma have been well described, it is easy to confuse mucoepidermoid carcinoma with the more common primary adenocarcinoma or squamous cell carcinoma of the lung. The features distinguishing mucoepidermoid carcinoma from other primary neoplasms includ 1) mucus-secreting cells individually and in clusters admixed with other cell components, 2) epidermoid cells identified by the presence of abundant spread-out cytoplasm and an oval dark nucleus and 3) intermediate cells resembiling normal ductal epithelial cells with moderate-toscanty cytoplasm, a central, round vesicular nucleus and a prominent nucleolus, The morphologic features of metastatic mucoepidermoid carcinoma in the case were similar to those of primary sallvary mucoepidermoid carcinoma.

Case Report

Cytopathologic Features of Adenoid Cystic of Trachea Carcinoma: Report of 2 Cases.: Young Mee Cho, So Young Park, In Chul Lee; Korean J Cytopathol. 1995;6(2):214-218.

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Abstract PDF: Cytopathologic findings of two cases of adenoid cystic carcinoma of the trachea are reported. The carcinomas grew as a intratracheal mass. By bronchial washing, brushing and/ or post-bronchoscopic sputum cytology, large cohesive sheets, lobulated clusters, or three dimensional ball-like structures were obtained. They had numerous cyst-like spaces containing characteristic globular basophilic material. The tumor cells were uniform and had a small amount of cytoplasm. Nuclei were small and hyperchromatic. Nucleoli were occasionally observed. The cytological diagnosis was confirmed by bronchoscopic biopsies.

Original Article

Effectiveness of Transbronchial Fine Needle Aspiration in Diagnosing Lung Cancers.: Tae Yub Kim, Gyung Yub Gong, Won Dong Kim, On Ja Kim; Korean J Cytopathol. 1997;8(2):109-114.

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Abstract PDF: Transbronchial fine needle aspiration(TBNA) is one of the cytologic methods in diagnosing lung cancers. TBNA can be used in cases of hilar, mediastinal or lung masses adjacent to the bronchi. We analyzed and compaired the findings of 27 cases of TBNA and bronchial washing and brushing(BW/BB) in lung cancers confirmed by either biopsy or surgical resection between Jun, 1996 and May, 1997 in Asan Medical Center. They were 18 cases of non-small cell carcinomas(eight squamous cell carcinomas, nine adenocarcinomas, and one large cell undifferentiated carcinoma), eight cases of small cell carcinomas, and one case of metastatic hepatocellular carcinoma. The sensitivity of TBNA was 37%(10/27) and false negative was 63%(17/27). Although the sensitivity of BW/BB was 56%(15/27), it was not different statistically from that of TBNA(Chi square, p=0.38). Overall sensitivity of TBNA and BW/BB in this series was 70%(19/27). Forty-seven percent of false negative TBNA(8/17) were positive in BW/BB. The findings suggest that the addition of TBNA to the standard BW/BB increases diagnostic yield in cytologic diagnosis of lung cancer.

Case Report

Bronchial Brushing and Bronchial Washing Cytologic Features of Primary Malignant Fibrous Histiocytoma of the Lung: A Case Report .: Mi Ok Park, Wook Su Ahn; Korean J Cytopathol. 1999;10(2):151-155.

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Abstract PDF: A case of primary malignant fibrous histiocytoma(MFH) of the lung occurring in a 62-year-old man is presented. After preoperative bronchial brushing and washing cytologic diagnosis of poorly differentiated carcinoma, surgical resection and lymph nodes dissection were performed. Subsequent histologic examination revealed a primary MFH. The diagnosis was confirmed by electron microscopic and immunohistochemical examinations. The review of the bronchial brushing and washing cytologic features disclosed many bipolar and a few unipolar spindle tumor cells with a "comet" configuration, mainly single cells, but also forming loose clusters. The nuclei were elongated and hyperchromatic and contained one or more irregular nucleoli. Scattered bizarre, multinucleated tumor giant cells were also present.

Original Article

Diagnostic Sensitivity of Sputum and Bronchial Washing Cytology in Bronchogenic Carcinomas Confirmed by Bronchoscopic Biopsy .: Joon Mee Kim, Soo Kee Min, Young Chae Chu, Chul Ho Cho; Korean J Cytopathol. 2001;12(1):17-23.

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Abstract PDF: To evaluate the role of sputum and bronchial washing for the diagnosis of lung carcinoma, we studied the sensitivity of both cytologic techniques using the biopsy confirmed cases from 228 patients. Among them, 123 cases were squamous cell carcinomas, 42 cases were adenocarcinomas, 48 cases were small cell carcinomas, one case was large cell carcinoma, and 14 cases were other types of carcinoma including poorly differentiated carcinomas. Three hundreds and ninety two sputa and 173 sputa were obtained in the pre- and post- bronchoscopic periods. Bronchial washing had been taken once in each patient. The overall sensitivity of the sputum cytology was 0.52 and that of the bronchial washing 0.63, while it increased to 0.83 when a combination of both techniques. Squamous cell carcinomas were diagnosed to the great extent in which sensitivities were 0.59 and 0.74, in sputum and bronchial washing, respectively. The post-bronchoscopic sputa showed higher sensitivity (0.44) than pre-bronchoscopic sputa (0.30). The sensitivity of sputa increased from 0.34 to 0.49 when three samples were examined compared to the single examination. The accuracy of cell typing was 94.0% in sputa and 93.8% in bronchial washing. Repeated sputum examination including post- bronchoscopic sputa is warranted to improve sensitivity and a complementary role of both cytologic techniques can be postulated by these data.

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