Journal of Pathology and Translational Medicine

Case Report

Liquid-Based Pap Smear Findings of Uterine Cervical Lymphoma: Three Cases Report.: Jiyoung Kim, Hyesun Kim, Sung Ran Hong, Yi Kyeong Chun, Hy Sook Kim; Korean J Pathol. 2011;45(4):437-440.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.437

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Abstract PDF: Malignant lymphoma of the uterine cervix is rarely diagnosed by cytology because it presents as a subepithelial mass. We report three cases of diffuse large B-cell lymphoma in the uterine cervix with a description of liquid-based pap smear (LBP) findings. All patients were presented with cervical masses, but a suspicion of malignant lymphoma was made in only one case by preoperative LBP. The LBP of two cases showed several atypical lymphoid cells in a clear background. The other case revealed numerous atypical lymphoid cells in a necrotic background. Most tumor cells had an increased N/C ratio, round but focally irregular nuclei, coarse chromatin, and prominent nucleoli. Nuclear blebing, dimpling, and multi-lobulation were also found. Diagnosis of malignant lymphoma by LBP is usually more difficult than by conventional techniques, because of a sparse numbers of cells and the lack of necrotic background. However, well preserved morphological features and a better resolution of nuclear details could be the benefits of LBP.

Original Articles

Clinical Usefulness of SurePath(TM) Liquid-based Cytology in Thyroid Fine Needle Aspiration: Comparison with the Conventional Smear in Diagnostic Efficacy and Applicability of BRAF Mutation Test.: Wook Youn Kim, Sang Hwa Lee, Young Sin Ko, So Dug Lim, Wan Seop Kim, Hye Seung Han, Hye Sil Seol, Seo Young Oh, Won Jin Moon, Tae Sook Hwang; Korean J Pathol. 2011;45(2):188-195.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.188

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BACKGROUND
Recently, liquid-based cytology (LBC) has been introduced as an alternative to the conventional smear (CS) technique in thyroid fine needle aspiration, due to its diagnostic convenience.
METHODS
We assessed 77 cases of thyroid fine needle aspiration using the SurePath(TM) method (SP) as LBC and CS via split-sample techniques. BRAF mutation tests were carried out via polymerase chain reaction and pyrosequencing immediately after diagnosis or a delay of more than one year.
RESULTS
In a comparison between SP and CS, the rate of concordance between SP and CS was as high as 84.4% (kappa value, 0.754). In comparison with histologic diagnosis, the overall sensitivity was 100% for both. The specificity was 62.5% for SP and 56.3% for CS. Relative to CS, papillary carcinomas on SP slides revealed more accentuated nuclear irregularities, nucleoli, and reduced nuclear size. In contrast to CS, the delayed BRAFV600E mutation test using SP slides after 1-2 years failed. The use of new primers amplifying shorter product size could help the delayed test achieve success.
CONCLUSIONS
Differences in the diagnostic efficacy of SP and CS were negligible. The failure of the delayed BRAF mutation test on the SP slides might be associated with DNA degradation.

Citations

Citations to this article as recorded by

Comparison of Liquid-Based Preparations with Conventional Smears in Thyroid Fine-Needle Aspirates: A Systematic Review and Meta-Analysis
Yun Jin Kang, Hyeon Woo Lee, Gulnaz Stybayeva, Se Hwan Hwang
Cancers.2024; 16(4): 751. CrossRef
Liquid‐based cytology of pigmented phaeohyphomycotic lesion of the palm masquerading as a metastatic tumor
Thara Keloth, Debasis Gochhait, S Sivaranjani, Neelaiah Siddaraju
Diagnostic Cytopathology.2019; 47(8): 828. CrossRef
DNA degradation in liquid‐based cytology and its comparison with conventional smear
Wook Youn Kim, Seo Young Oh, Hyunkyung Kim, Tae Sook Hwang
Diagnostic Cytopathology.2016; 44(5): 450. CrossRef
Comparison of EASYPREP® and SurePath® in thyroid fine‐needle aspiration
Yosep Chong, Ki Hyun Baek, Jee Young Kim, Tae‐Jung Kim, Eun Jung Lee, Chang Suk Kang
Diagnostic Cytopathology.2016; 44(4): 283. CrossRef
Conventional smears versus liquid-based preparations for thyroid fine-needle aspirates: a systematic review and meta-analysis
Neeraja Nagarajan, Alireza Najafian, Eric B. Schneider, Martha A. Zeiger, Matthew T. Olson
Journal of the American Society of Cytopathology.2015; 4(5): 253. CrossRef
Liquid‐based cytology improves preoperative diagnostic accuracy of the tall cell variant of papillary thyroid carcinoma
Sung Hak Lee, Chan Kwon Jung, Ja Seong Bae, So Lyung Jung, Yeong Jin Choi, Chang Suk Kang
Diagnostic Cytopathology.2014; 42(1): 11. CrossRef
Stability of DNA, RNA, cytomorphology, and immunoantigenicity in Residual ThinPrep® Specimens
Younghye Kim, Kap Ro Choi, Moon Jung Chae, Bong Kyung Shin, Han Kyeom Kim, Aeree Kim, Baek‐hui Kim
APMIS.2013; 121(11): 1064. CrossRef
The Development of the Liquid Cell Smear Device for Liquid-Based Cytology Test
Han Yeong Oh, Ha Ju So, Seong Hyun Kim, Dong Wook Kim, Hyun Chang Kim
Applied Mechanics and Materials.2013; 284-287: 1564. CrossRef

Comparison of Liquid-based (SurePath(TM)) and Conventional Preparations in Thyroid Fine Needle Aspiration.: Seoung Wan Chae, Sun Hee Kim, Hee Dae Park, Woon Sun Park, Young Hye Cho, Sung Hee Kang, Dong Hoon Kim, Jin Hee Sohn; Korean J Pathol. 2010;44(6):651-656.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.651

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Abstract PDF

BACKGROUND
The aim of this study was to evaluate differences in cytologic findings between conventional preparation (CP) and SurePath(TM) liquid-based preparation (LBP) in thyroid fine needle aspiration (FNA).
METHODS
We analyzed cytological features on a total of 182 thyroid FNAs (83 CP and 99 LBP) that were histologically confirmed as nodular hyperplasia (NH) or papillary carcinoma (PAC).
RESULTS
LBP was superior in cellular preservation and cellularity than CP. Interestingly, in LBP, cellularity of NH was similarly high compared to that of PAC. The three-dimensional pattern was more prominent in LBP than in CP. The presence of follicle structures was more frequently found in LBP than in CP in the PAC group. Dispersed single cells in the background were more prominent in LBP than in CP. In the PAC group, contrast of the nuclear membrane was more distinctive in CP than in LBP.
CONCLUSIONS
In thyroid FNA, LBP is better for cellular preservation, cellularity, background and nuclear detail than CP. However, some features in LBP such as high cellularity in NH, prominent dispersed single cells, and frequent follicle patterns were unfamiliar findings in CP. Hence, we should be aware of these cytomorphologic features in LBP to make a proper diagnosis.

Citations

Citations to this article as recorded by

Comparison of EASYPREP® and SurePath® in thyroid fine‐needle aspiration
Yosep Chong, Ki Hyun Baek, Jee Young Kim, Tae‐Jung Kim, Eun Jung Lee, Chang Suk Kang
Diagnostic Cytopathology.2016; 44(4): 283. CrossRef

Evaluation of the Manual Method of Liquid-Based Uterine Cervicovaginal Cytology - By The Manual Method Based on SurePathTM Methodology.: Jong Myoung Park, Jin Wook Jang, So Yeo Lim, Jong Gi Lee, In Soo Suh; Korean J Cytopathol. 2004;15(2):86-91.

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Abstract PDF: Liquid-Based Uterine Cervicovaginal Cytology is known to be a sensitive and effective screening method for cervical neoplasm. MonoPrepTM, ThinPrepTM, and SurePathTM methods have been recently used as Liquid- Based Uterine Cervicovaginal Cytology techniques, and the SurePathTM method has been used in Sung-Yoon Reference Laboratory since 2003. The goal of Liquid-Based Uterine Cervicovaginal Cytology is to separate cervical epithelial cells from non-target cells, red blood cells and neutrophils. This report describes a study which evaluated cellularity, stainability, and cellular changes of epithelial cells in samples processed using a manual technique as compared to samples processed using SurePathTM automated method. The samples processed by means of a manual technique contained a cellularity of epithelial cells similar to that of the samples processed using the SurePathTM automated method. In addition, we compared variable density gradient reagents, including dextran, dextrose, and sucrose, to SurePathTM gradient media in order to evaluate cell fractionation and cellularity of epithelial cells. 10% dextran of gradient media shows good fractionation. The samples processed with 10% dextran demonstrated sufficient cellularity of epithelial cells and shows the fewest cellular changes. In conclusion, using a manual technique on these samples is easier to read than those results obtained using the SurePathTM automated method.

A Comparision of Surepath(TM) Liquid-Based Smear with a Conventional Smear for Cervicovaginal Cytology-with Reference to a Histological Diagnosis.: Kyung Chul Lee, Chan Kwon Jung, Ahwon Lee, Eun Sun Jung, Yeong Jin Choi, Jong Sup Park, Kyo Young Lee; Korean J Cytopathol. 2007;18(1):20-28.

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Abstract PDF: This study was performed to compare Surepath(TM) liquid-based smear and a conventional cervicovaginal smear with reference to a histological diagnosis. A hybrid capture test (HCII) was also performed and analyzed. We collected matched cases for cervicovaginal cytology- histology: 207 cases for conventional cytology (CC) and 199 cases for liquid-based cytology (LBC). HCII was performed in 254 patients. When a cytological diagnosis of ASCUS or above (ASCUS+) is classified as positive and a histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for LBC was 91.7% and 75.9%, respectively and the sensitivity and specificity for CC was 62.6% and 96.1%, respectively. When a cytological and histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for LBC was 77.5 and 96.6%, respectively and the sensitivity and specificity for CC was 49.7% and 100%, respectively. When a histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for HCII was 78.9% and 78.1%, respectively. The concordance ratio between the cytological and histological diagnosis was 80.4% (kappa=76.0) for LBC and 56.5% (kappa=55.1) for CC. LBC is more sensitive and less specific then CC, as a cytological cutoff level of ASCUS, but more sensitive and equally specific, as a cytological cutoff level LSIL or HSIL. LBC is more reliable with a high concordance ratio between the cytological and histological diagnosis.

The Usefulness of SurePath(TM) Liquid-Based Smear in Sono-Guided Thyroid Fine Needle Aspiration; a Comparison of a Conventional Smear and SurePath(TM) Liquid-Based Cytology.: Dong Hoon Kim, Min Kyung Kim, Seoung Wan Chae, Kyoung Bun Lee, Eun Mee Han, Sung Hee Kang, Jin Hee Sohn; Korean J Cytopathol. 2007;18(2):143-152.

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Abstract PDF: Sono-guided fine needle aspiration (FNA) of the thyroid is widely used, but the aspirated samples are typically not well preserved and low cellularity makes diagnosis difficult in many cases. The object of the current study is to evaluate the adequacy and diagnostic accuracy of the use of SurePath(TM) liquid-based cytology (SP-LBC) in the sonoguided fine needle aspiration of the thyroid nodule and to compare its use with that of the use of a conventional smear (CS). A total of 172 sono-guided FNAs of thyroid nodules from April to June, 2006 were prepared by the use of the split method with either SP-LBC or CS; the samples were stained with the use of hematoxylin-eosin (H&E) and Papanicolaou (Pap) stains. A cyto-histological correlation was performed in 69 (30 SP and 39 CS) cases that had been histologically confirmed. The rate of producing unsatisfactory slides by the use of the SP-LBC method (9.3%) was less than that of the use of the CS method (20.9%). The diagnostic accuracy of the SP method (93.3%) was better than that of the CS method (85.3%). The sensitivity and specificity of the SP method (94.4% and 92.3%) was better than that of the CS method (83.3% and 70%), respectively (p<0.05). The CS of sono-guided aspirated specimens had some unavoidable limitations related to inadequate sampling such as a bloody background, low cellularity and an indication that some clinicians smeared many useless slides (averaging four to ten slides), and that most slides showed only blood that included few follicular cells. The SP method resulted in more thinly smeared slides and showed cleaner background and greater cellularity than the use of the CS method. Each follicular cell shows superior nuclear detail, and more distinct cytoplasmic features than with the use of the CS method. SP-LBC appears to be an easy, highly accurate, and reliable cytological method for employ for a diagnostic approach of thyroid disease and thyroid nodules. The SP-LBC method is a suitable alternative to the CS method to overcome diagnostic difficulties.

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