Journal of Pathology and Translational Medicine

Original Article

Cytomorphological Features of Hyperchromatic Crowded Groups in Liquid-Based Cervicovaginal Cytology: A Single Institutional Experience: Youngeun Lee, Cheol Lee, In Ae Park, Hyoung Jin An, Haeryoung Kim; J Pathol Transl Med. 2019;53(6):393-398. Published online September 16, 2019; DOI: https://doi.org/10.4132/jptm.2019.08.14

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Background
Hyperchromatic crowed groups (HCGs) are defined as three-dimensional aggregates of crowded cells with hyperchromatic nuclei, and are frequently encountered in cervicovaginal liquid-based cytology (LBC). Here, we aimed to examine the prevalence of HCGs in cervicovaginal LBC and the cytomorphological characteristics of various epithelial cell clusters presenting as HCGs.
Methods
We first examined the prevalence of HCGs in a “routine cohort” of LBC cytology (n=331), consisting of all cervicovaginal LBCs accessioned over 3 days from outpatient clinics (n=179) and the screening population (n=152). Then we examined a second “high-grade epithelial cell abnormalities (H-ECA) cohort” (n=69) of LBCs diagnosed as high-grade squamous intraepithelial lesion (HSIL), squamous cell carcinoma (SCC), or adenocarcinoma during 1 year.
Results
HCGs was observed in 34.4% of the routine cohort and were significantly more frequent in the epithelial cell abnormality category compared to the non-neoplastic category (p=.003). The majority of HCGs represented atrophy (70%). Of the 69 histologically confirmed H-ECA cases, all contained HCGs. The majority of cases were HSIL (62%), followed by SCC (16%). Individually scattered neoplastic cells outside the HCGs were significantly more frequent in SCCs compared to glandular neoplasia (p=.002). Despite the obscuring thick nature of the HCGs, examining the edges and the different focal planes of the HCGs and the background were helpful in defining the nature of the HCGs.
Conclusions
HCGs were frequently observed in cervicovaginal LBC and were mostly non-neoplastic; however, neoplastic HCGs were mostly high-grade lesions. Being aware of the cytomorphological features of different HCGs is important in order to avoid potential false-negative cytology interpretation.

Citations

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Can Mitotic Figures in Hyperchromatic Crowded Groups be Cytodiagnostic Criteria for High-Grade Squamous Intra-epithelial Lesions?
Hisae Suzuki, Yumeno Kondo, Chihiro Oda, Takeshi Nishikawa, Mao Takeuchi, Shigenobu Tatsumi, Sho Hosokawa, Satoshi Irino, Tomoko Uchiyama, Tomomi Fujii, Yoshiaki Norimatsu
Journal of Cytology.2024; 41(2): 116. CrossRef
Atypical glandular cells (AGC): Cytology of glandular lesions of the uterine cervix
Mir Yousufuddin Ali Khan, Sudeshna Bandyopadhyay, Ahmed Alrajjal, Moumita Saha Roy Choudhury, Rouba Ali-Fehmi, Vinod B. Shidham
Cytojournal.2022; 19: 31. CrossRef
Cytopathologic features of human papillomavirus–independent, gastric-type endocervical adenocarcinoma
Min-Kyung Yeo, Go Eun Bae, Dong-Hyun Kim, In-Ock Seong, Kwang-Sun Suh
Journal of Pathology and Translational Medicine.2022; 56(5): 260. CrossRef
The association of atypical squamous cells, cannot exclude a high grade squamous intraepithelial lesion, hyperchromatic crowded groups and high grade squamous intraepithelial lesions involving endocervical glands
Suzanne M. Selvaggi
Diagnostic Cytopathology.2021; 49(9): 1008. CrossRef

Case Studies

Hyalinizing Trabecular Tumor of the Thyroid Gland, a Diagnostic Challenge in Fine-Needle Aspiration Cytology: Case Report: Ye-Young Rhee, Hong Kyu Jung, Se Hoon Kim, Soo Hee Kim; J Pathol Transl Med. 2018;52(4):252-256. Published online June 11, 2018; DOI: https://doi.org/10.4132/jptm.2018.04.28

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Abstract PDF

Hyalinizing trabecular tumor (HTT) is a rare thyroid tumor with low to minimal malignant potential. HTT is often misinterpreted as other thyroid tumors, including papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma (MTC), on fine-needle aspiration (FNA) cytology, because of its overlapping cytologic features, such as nuclear grooves and intranulcear pseudoinclusions. Although cytopathologists cannot definitely conclude HTT by FNA cytology, suspicion of HTT is necessary to avoid misdiagnosing HTT as PTC or MTC and to avoid unnecessary aggressive treatment. Here, we report a case of HTT with novel cytologic features in CellPrep liquid based cytology that was diagnosed as suspicious for papillary carcinoma by FNA and finally diagnosed as HTT in the surgical specimen.

Citations

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Cytomorphological traits of fine-needle aspirates of hyalinizing trabecular tumor of the thyroid gland: A brief report
Fei Wang, Yufei Liu
Indian Journal of Pathology and Microbiology.2024; 67(1): 128. CrossRef
Total thyroidectomy can still remain the method of choice in some Bethesda III cases
Jindrich Lukas, Barbora Hintnausova, Vlasta Sykorova, Martin Syrucek, Marek Maly, Jaroslava Duskova
Biomedical Papers.2023; 167(1): 61. CrossRef
Diagnostic clues for hyalinizing trabecular tumor on fine needle aspiration cytology
Lone Nielsen, Ana María Colino Gallardo, Pablo Pérez Alonso, Luis Ortega Medina, Esthefanía Latorre García, Cristina Díaz del Arco, Reyes Bergillos Jiménez, Lorenzo Alarcón García, Marta Cruz Blanco, Jesús Vega González, Montserrat De la Torre Serrano, Ma
Cytojournal.2023; 20: 19. CrossRef
Clinical Characteristics of the Hyalinizing Trabecular Tumor
Byung-Chang Kim, Shin Jeong Pak, Jae Won Cho, Won Woong Kim, Yu-mi Lee, Tae-Yon Sung, Jung Hwan Baek, Ki-Wook Chung
Journal of Endocrine Surgery.2022; 22(4): 116. CrossRef
A Case of Multifocal Hyalinizing Trabecular Tumors of the Thyroid Gland
Suhwan Jeong, Hanaro Park
Journal of Clinical Otolaryngology Head and Neck Surgery.2021; 32(3): 308. CrossRef
The Diagnosis of Hyalinizing Trabecular Tumor: A Difficult and Controversial Thyroid Entity
Esther Diana Rossi, Mauro Papotti, William Faquin, Luigi Maria Larocca, Liron Pantanowitz
Head and Neck Pathology.2020; 14(3): 778. CrossRef
A large series of hyalinizing trabecular tumors: Cytomorphology and ancillary techniques on fine needle aspiration
Marco Dell’Aquila, Carmen Gravina, Alessandra Cocomazzi, Sara Capodimonti, Teresa Musarra, Stefania Sfregola, Vincenzo Fiorentino, Luca Revelli, Maurizio Martini, Guido Fadda, Liron Pantanowitz, Luigi Maria Larocca, Esther Diana Rossi
Cancer Cytopathology.2019; 127(6): 390. CrossRef
GLIS rearrangements in thyroid nodules: A key to preoperative diagnosis of hyalinizing trabecular tumor
Marina N. Nikiforova, Yuri E. Nikiforov, N. Paul Ohori
Cancer Cytopathology.2019; 127(9): 560. CrossRef

Merkel Cell Carcinoma Metastatic to Pleural Fluid: A Case Report: Ye-Young Rhee, Soo Hee Kim, Eun Kyung Kim, Se Hoon Kim; J Pathol Transl Med. 2018;52(3):206-209. Published online November 23, 2017; DOI: https://doi.org/10.4132/jptm.2017.11.10

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Abstract PDF

Merkel cell carcinoma (MCC) is a rare aggressive neuroendocrine carcinoma of the skin that shows locoregional or distant metastasis. Metastasis of MCC to body cavity effusion is extremely rare; only three cases have been reported so far. Metastatic MCC in effusion cytology shows small blue round cells with fine stippled chromatin like other small blue round cell tumors such as small cell lung carcinoma or lymphoma. The diagnosis of metastatic MCC can grant patients good chances at recently advanced therapeutic options. Here, we present a case of metastatic MCC to pleural effusion with characteristic single file-like pattern.

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Merkel cell carcinoma presenting as a malignant pleural effusion post‐COVID‐19 hospitalization: A case report and literature review
Joel Lanceta, Mesut Toprak, Oana C. Rosca
Diagnostic Cytopathology.2022;[Epub] CrossRef
Cytology coupled with immunocytochemistry identifies Merkel cell carcinoma: A rare intruder in the cerebrospinal fluid
Reetu Kundu, Brijdeep Singh, Pranab Dey
Cytopathology.2022; 33(4): 530. CrossRef
Derrame pleural por carcinoma de células de Merkel
María J. Soler-Sempere, María O. Alvárez-Fernández, Isabel Padilla-Navas, María Cabezas-Macián, Jose F. Sánchez-Hernández, Eduardo García-Pachón
Archivos de Bronconeumología.2021; 57(11): 715. CrossRef
A rare case of pleural localisation of both metastatic Merkel cell carcinoma and chronic lymphocytic leukaemia
Elise Kaspi, Shirley Fritz, Julien Colle, Florent Amatore, Diane Frankel, Patrice Roll
Cytopathology.2021; 32(3): 367. CrossRef
Merkel cell carcinoma with pleural effusion
María J. Soler-Sempere, María O. Alvárez-Fernández, Isabel Padilla-Navas, María Cabezas-Macián, Jose F. Sánchez-Hernández, Eduardo García-Pachón
Archivos de Bronconeumología (English Edition).2021; 57(11): 715. CrossRef

Liquid-Based Cytology of the Cerebrospinal Fluid in a Case of Cryptococcal Meningitis: Jiwoon Choi, Se Hoon Kim; J Pathol Transl Med. 2018;52(1):61-63. Published online October 26, 2017; DOI: https://doi.org/10.4132/jptm.2017.06.13

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Abstract PDF

Cryptococcus neoformans is the most common microorganism found in cerebrospinal fluid (CSF) cytology and causes life-threatening infections in immunocompromised hosts. Although its cytomorphologic features in conventional smear cytology have been well described, those in liquid-based cytology have rarely been. A 73-year-old woman with diffuse large B-cell lymphoma presented with mental confusion and a spiking fever. To rule out infectious conditions, CSF examination was performed. A cytology slide that was prepared using the ThinPrep method showed numerous spherical yeast-form organisms with diameters of 4–11 μm and thick capsules. Occasional asymmetrical, narrow-based budding but no true hyphae or pseudohyphae were observed. Gomori methenamine silver staining was positive. Cryptococcosis was confirmed in blood and CSF through the cryptococcal antigen test and culture. Liquid-based cytology allows for a clean background and additional slides for ancillary testing, facilitating the detection of microorganisms in CSF specimens, particularly when the number of organisms is small.

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Unraveling Capsule Biosynthesis and Signaling Networks in Cryptococcus neoformans
Eun-Ha Jang, Ji-Seok Kim, Seong-Ryong Yu, Yong-Sun Bahn, Teresa R. O’Meara
Microbiology Spectrum.2022;[Epub] CrossRef
Cerebrospinal fluid pleocytosis in immunocompromised patients: Can it be Cryptococcus
Ridhi Sood, Ruchita Tyagi, Pavneet Selhi, Harpreet Kaur, Neena Sood
Diagnostic Cytopathology.2020; 48(2): 164. CrossRef
Special Staining of the Liquid-Based Cytopathology Test in Bronchoalveolar Lavage Fluid for Diagnosis of Invasive Pulmonary Aspergillosis with Nonneutropenic Patients
Yue Hu, Lin Zheng, Deng Pan, Lei Shao, Xianfa Xu, Yiming Yu, Qidong Zhuang, Zaichun Deng, Zhongbo Chen
Canadian Respiratory Journal.2020; 2020: 1. CrossRef
Sensitivity of Cerebrospinal Fluid Cytology for the Diagnosis of Cryptococcal Infections
Kelsey E McHugh, Melanie Gersey, Daniel D Rhoads, Gary W Procop, Yaxia Zhang, Christine N Booth, Charles D Sturgis
American Journal of Clinical Pathology.2019; 151(2): 198. CrossRef
Cryptococcal Capsules in Cerebrospinal Fluid Visible on Hemocytometer
Zen Kobayashi, Yuriko Hirota, Shuzo Shintani
Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.2018; 45(6): 700. CrossRef

Original Article

Comparison of Unsatisfactory Samples from Conventional Smear versus Liquid-Based Cytology in Uterine Cervical Cancer Screening Test: Hoiseon Jeong, Sung Ran Hong, Seoung-Wan Chae, So-Young Jin, Hye Kyoung Yoon, Juhie Lee, Eun Kyung Kim, Sook Tai Ha, Sung Nam Kim, Eun-Jung Park, Jong Jae Jung, Sun Hee Sung, Sung-chul Lim; J Pathol Transl Med. 2017;51(3):314-319. Published online April 17, 2017; DOI: https://doi.org/10.4132/jptm.2017.03.17

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Abstract PDF

Background
Cervical cytology for uterine cervical cancer screening has transitioned from conventional smear (CS) to liquid-based cytology (LBC), which has many advantages. The aim of this study was to compare the proportion of unsatisfactory specimens from CS versus LBC at multiple institutions including general hospitals and commercial laboratories.
Methods
Each participating institution provided a minimum of 500 Papanicolaou (Pap) test results for analysis. Pap tests were classified according to the participating institution (commercial laboratory or general hospital) and the processing method (CS, ThinPrep, SurePath, or CellPrep). The causes of unsatisfactory results were classified as technical problems, scant cellularity, or complete obscuring factors.
Results
A total of 38,956 Pap test results from eight general hospitals and three commercial laboratories were analyzed. The mean unsatisfactory rate of LBC was significantly lower than that of CS (1.26% and 3.31%, p = .018). In the LBC method, samples from general hospitals had lower unsatisfactory rates than those from commercial laboratories (0.65% vs 2.89%, p = .006). The reasons for unsatisfactory results were heterogeneous in CS. On the other hand, 66.2% of unsatisfactory results in LBC were due to the scant cellularity.
Conclusions
Unsatisfactory rate of cervical cancer screening test results varies according to the institution and the processing method. LBC has a significantly lower unsatisfactory rate than CS.

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Journal of Clinical Practice.2023; 14(1): 108. CrossRef
The Role of p16/Ki67 Dual Staining in Cervical Cancer Screening
Andraž Dovnik, Alenka Repše Fokter
Current Issues in Molecular Biology.2023; 45(10): 8476. CrossRef
Evaluation of a Novel Fixative Solution for Liquid-Based Cytology in Diagnostic Cytopathology
Nadia Casatta, Alessia Poli, Sara Bassani, Gianna Veronesi, Giulio Rossi, Clarissa Ferrari, Carmelo Lupo
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Liquid-Based cytology in the detection of premalignant lesions in patients with “atypia in squamous cells” in conventional cytology
Lia Barrios, Yoled Vizcaíno, Ines Benedetti
Journal of Cytology.2022; 39(4): 148. CrossRef
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Virchows Archiv.2021; 478(3): 507. CrossRef
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Case Reports

Liquid-Based Cytology of Villoglandular Adenocarcinoma of the Cervix: A Report of 3 Cases: Younghwa Choi, Haeryoung Kim, Haiyoung Choi, Daehyun Hwang, Gheeyoung Choe, Jin-Haeng Chung, So Yeon Park, Hye Seung Lee, Jin Ho Paik, Hyo Jin Park; Korean J Pathol. 2012;46(2):215-220. Published online April 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.215

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Abstract PDF

Villoglandular adenocarcinoma (VGA) is a rare subtype of cervical adenocarcinoma with a more favorable prognosis compared to conventional adenocarcinomas. Although the tumors are usually recognized on colposcopic examination due to the mainly exophytic growth pattern, they may be underdiagnosed as benign lesions by cytology because of their minimal cytologic atypia. We report the liquid-based cytology (LBC) findings of three histologically confirmed VGAs which we have recently identified. They were characterized by hypercellular smears on low-power examination with smooth-bordered three-dimensional papillary fragments. The nuclei were relatively uniform with irregular nuclear membranes. Nucleoli were small but distinct and macronucleoli were also seen. The abnormal architectural patterns such as papillary structures and nuclear overlapping and nuclear hyperchromasia are important clues to the diagnosis of VGA. In addition, nuclear membrane irregularity and prominent nucleoli can be recognized on LBC specimens, further facilitating its diagnosis.

Citations

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Villoglandular adenocarcinoma of the uterine cervix: a systematic review and meta-analysis
Anna K. Dietl, Matthias W. Beckmann, Konrad Aumann
Archives of Gynecology and Obstetrics.2021; 304(2): 317. CrossRef
Les lésions glandulaires du col utérin : cas no 4
Catherine Genestie, Chiraz Hadj Kacem, Pierre Duvillard
Annales de Pathologie.2016; 36(3): 192. CrossRef

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

The Cytology for Leukemic Cells in Cerebrospinal Fluid; Comparison of Conventional Cytology with Liquid-Based Cytology.: Changyoung Yoo, Youn Soo Lee, Chang Suk Kang, Sang In Shim, Kyo Young Lee; Korean J Pathol. 2009;43(2):164-170.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.2.164

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Abstract PDF: BACKGROUND
The cytological examination of cerebrospinal fluid (CSF) using conventional cytology with a cytocentrifuge (cytospin) is an important method for evaluating the involvement of leukemia in the CNS. Liquid-based cytology (LBC) is now a widely used cytological method not only for gynecological and non-gynecological specimens, but its application to CSF for the identification of leukemic cell has not yet been reported. In this study, we tried to compare conventional cytology with using a cytospin with LBC and Papanicolaou (Pap) staining. We also examined the modified LBC with Wright staining to assess whether this modified method can be useful for diagnosing Leukemia.
METHODS
We studied 30 cases of CSF that were obtained from 16 patients, including 17 cases of acute myeloid leukemia, 12 cases of acute lymphoblastic leukemia and 1 case of diffuse large B cell lymphoma. We applied conventional cytology with a cytocentrifuge (cytospin), LBC with Pap staining and modified LBC with Wright staining.
RESULTS
The morphological features of the LBC with Pap staining showed difficulty for interpretation when compared with conventional cytology with a cytospin, and mainly because of cellular shrinkage. The modified LBC with Wright staining showed good morphological features.
CONCLUSIONS
We suggest that modified LBC with Wright staining may be useful for examining CSF.

Liquid-Based Cytology Using MonoPrep2(TM) System in Cervicovaginal Cytology: Comparative Study with Conventional Pap Smear and Histology.: Yoon Kyung Jeon, Ok Ran Kim, Ki Wha Park, Soon Beom Kang, In Ae Park; Korean J Cytopathol. 2004;15(1):33-39.

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Abstract PDF: We compared the diagnostic accuracy of liquid-based cervicovaginal cytology using MonoPrep2(TM) system (Monogen, Herndon, Virginia, USA), a manual system based on membrane filtration method, with conventional Pap smear. Study population included 92 patients visiting the gynecologic department under the suspicion of uterine cervical disease. In thirty of them, surgical biopsy was performed. MonoPrep2(TM) system provided well-preserved monolayer specimen with good nuclear morphology. However, about 19% of specimens were inadequate to interpret due to low cellularity. The detection rate of abnormal cells more than ASCUS (atypical squamous cells of unknown significance) was 23.9% and higher than 19.4 % of conventional Pap smear. Diagnostic concordance rate with conventional Pap smear was 81%, and severe discordance rate influencing on the management of patient was 7.6 %. Among these seven cases, MonoPrep2(TM) system was more diagnostic only in four. In comparison with histology, the sensitivity of diagnosis of MonoPrep2(TM) system was 78.9% and slightly higher than 73.5% of conventional Pap smear. However, the specificity was 81.1% and lower than 90.9% of Pap smear. In conclusion, MonoPrep2(TM) system provided diagnostic accuracies similar to the conventional Pap smear. The inexpertness of slide preparation and the low cellularity were considered to endow a limitation in more accurate evaluation.

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.

Cytologic Evaluation of CellPrep(R) Liquid-based Cytology in Cervicovaginal, Body Fluid, and Urine Specimens: Comparison with ThinPrep(R).: Jae Soo Koh, Soo Yeon Cho, Hwa Jeong Ha, Jung Soon Kim, Myung Soon Shin; Korean J Cytopathol. 2007;18(1):29-35.

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Abstract PDF: This study purposed to evaluate a CellPrep(R) (CP) of liquid-based cytology (LBC) to search for a less expensive and automated alternative cytologic preparation technique applicable to usually encountered cytologic specimens. Cervicovaginal direct-to-vial split samples from 457 gynecologic patients, 40 body fluid samples, and 34 urine samples were processed with the CP technique and the results were compared with those of currently used ThinPrep(R) (TP) method. Both CP and TP methods provide evenly distributed thin layers of cells with little cellular overlaps or significant obscuring elements in most of cases. Staining quality of both preparations showed a little difference due to the difference of fixative solutions without significant distractions in cytologic interpretation. On the supposition that TP was a gold standard, sensitivity, specificity, positive predictive value, and negative predictive value of CP cytology were 89%, 98%, 86%, and 99% in the cervicovaginal smear, 89%, 82%, 80%, and 90% in body fluid, and all of these values were 100% in urine samples. To testify the availability of immunohistochemistry on CP preparations, cytokeratin, vimentin, and Ki-67 were applied on body fluid specimens, and all of these antibodies were specifically stained on targeted cells. Conclusively, the CP method gave comparable results to those of TP in terms of smear quality and cytologic diagnostic evaluation, and was available on immunohistochemistry. The CP method could offer a cost-effective and automated alternative to the current expensive techniques of liquid- based cytology on popular cytologic materials including cervicovaginal, body fluid, and urine specimens.

Diagnostic Value of Urine Cytology in 236 cases; a Comparison of Liquid-Based Preparation and Conventional Cytospin Method.: Sun Lee, Jung Hee Park, Sung Im Do, Youn Wha Kim, Juhie Lee, Sung Gu Chang, Yong Koo Park; Korean J Cytopathol. 2007;18(2):119-125.

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Abstract PDF: Urine cytology is an important screening tool for urinary tract neoplasms. Liquid-based preparation methods, such as ThinPrep(R), have been introduced for non-gynecological samples. We aimed to assess the diagnostic accuracy of liquid-based preparations in urine cytology by comparing the results of the conventional Cytospin preparation method for the same samples. A total of 236 cases subject to urine cytology were enrolled in this study from January 2005 to December 2005. All cases were subjected to cystoscopy and if a malignancy was suspected, a biopsy was performed. Urine cytology slides were made using the ThinPrep(R) preparation method and the conventional Cytospin and/or direct smear method from the individual samples. The results of urine cytology were compared with the final cystoscopic or histological diagnoses. We analyzed the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of both cytology preparation methods. A total of 236 slides made using the liquid based method were satisfactory for slide quality, whereas 5 slides (2.1%) prepared by conventional methods were unsatisfactory because of air-drying, a thick smear, or a bloody or inflammatory background. The ThinPrep(R) method showed 53.1% sensitivity, 92.6% specificity, a 92.6% positive predictive value, a 94.1% negative predictive value and 85.6% accuracy, while the conventional method showed 51% sensitivity, 98.4% specificity, a 92.6% positive predictive value, a 98.4% negative predictive value and 88.6% accuracy. Although the diagnostic values were equivalent between the use of the two methods, the quality of the cytology slides and the time consumed during the microscopic examination for a diagnosis were superior for the ThinPrep(R) method than for the conventional method. In conclusion, our limited studies have shown that the use of the liquid based preparation method is beneficial to improve the quality of slides and reduce the duration for a microscopic examination, but did not show better sensitivity, accuracy and predictive values.

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