EVALUATION OF CELL BLOCK TECHNIQUE VERSUS CONVENTIONAL CYTOLOGY ON BRONCHOSCOPY GUIDED NEEDLE ASPIRATION/ BRUSH CYTOLOGY FOR DIAGNOSIS OF LUNG CANCER

2021 ◽  
pp. 64-66
Author(s):  
Manveer kour Raina ◽  
Neena Gupta ◽  
Sanjeev Kumar ◽  
Anuradha Kusum
Keyword(s):  
Gold Standard ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Cell Block ◽  
Brush Cytology ◽  
Conventional Cytology ◽  
Cytological Preparation ◽  
True Conclusion ◽  
Diagnosis Of Lung Cancer ◽  
Cytology Study

INTRODUCTION: Bronchoscopy is a safe and effective method for diagnosing lung carcinomas with a variation in the diagnostic yield with different bronchoscopy guided procedures. Cell block technique has shown an addition cases positivity in diagnosing carcinomas as compared to the conventional method. AIM: The present study was aimed to evaluate the diagnostic utility of cell block technique on Bronchoscopy guided needle aspiration/ Brush and also to compare cytological preparation with cell block. MATERIAL AND METHODS: A total of 50 cases were included in the study that was suspected to be having lung carcinoma. These patients went under bronchoscope guided aspirations (TBNA, EBNA, and Brush). Smears were immediately made for conventional cytology study and well as in another aliquot samples were collected to prepare cell blocks following which H&E staining was done. RESULTS: Out of 50 cases, 8 cases came out to be negative on conventional smears and when compared with cell block technique 4 additional cases came out to be positive who were negative on conventional smears. The diagnosis were compared with histopathology biopsies keeping it as a gold standard and results on cell block techniques were conrmed to be true. CONCLUSION: Out of 50 cases, an additional 4 more cases were diagnosed malignant by using the cell blocks technique but there were few drawbacks with cell block technique. In few of the cases on cell block, cellularity was very less, cells morphology was also not very clear and some showed cells entrapped in a clusters. The conclusion made out of this study is that cell block technique is more accurate than the cytological smears and when used in combination diagnostic efcacy will be improved.

scholarly journals Pull vs. wet: rendimiento diagnóstico y calidad de las muestras de las PAAF guiadas por USE en las masas sólidas del páncreas

2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Cecilia Curvale ◽  
Ignacio Málaga ◽  
Paloma Rojas Saunero ◽  
Viviana Tassi ◽  
Enrique Martins ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Double Blind Study ◽  
Cell Block ◽  
Ultrasound Guided ◽  
Double Blind ◽  
Fine Needle ◽  
Significant Difference

Differential diagnosis of pancreatic masses is challenging. The endoscopic ultrasound-guided fine-needle aspiration method with the highest diagnostic yield has not been established. It was realized a prospective, randomized, double-blind study of the endoscopic ultrasound-guided fine-needle aspiration in solid lesions of the pancreas to compare and evaluate diagnostic yield and aspirate quality between wet and pull technique. Forty-one patients were enrolled. The wet technique presented a sensitivity, a specificity, a positive and negative predictive value, and a diagnostic accuracy of 58.3%, 100%, 100%, 25% and 63.4%, respectively. In the capillary technique they were: 75%, 100%, 100%, 35.7% and 78.1%, respectively. Comparing the diagnostic yield between both techniques, there was no statistically significant difference (McNemar’s test p = 0.388). Regarding the cellularity of the specimen, both in cytology and the cell block samples, no significant difference was observed between the techniques (p = 0.84 and 0.61, respectively). With respect to contaminating blood in the specimen, there was no difference in cytology samples (p = 0.89) and no difference in cell block samples (p = 0.08). The suitability of cytology samples for diagnosis was similar in both techniques (wet = 57.5% and capillary = 56.7%, p = 0.94) and there was no difference in cell block samples (wet = 75% and capillary = 66.1%, p = 0.38). In this study we did not observe differences in diagnostic yield or sample quality. Since both techniques are effective, we suggest the simultaneous and alternate use of both methods.

TRANSBRONCHIAL NEEDLE ASPIRATION: IS POOLED CELL BLOCK, CYTOLOGY SLIDES, OR BOTH NEEDED TO IMPROVE DIAGNOSTIC YIELD?

CHEST Journal ◽  
2006 ◽  
Vol 130 (4) ◽  
pp. 147S
Author(s):  
Eric L. Flenaugh ◽  
Marshaleen N. Henriques ◽  
Seraj El-Oshar ◽  
Ananka Myrie ◽  
Gloria E. Westney
Keyword(s):  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Cell Block ◽  
Transbronchial Needle Aspiration

scholarly journals Transbronchial needle aspiration cytology of endobronchial abnormalities: does it increase the positivity rates of bronchoscopy

2014 ◽  
Vol 4 (7) ◽  
pp. 565-569
Author(s):  
B Thapa ◽  
R Sapkota ◽  
KR Shrestha ◽  
P Sayami ◽  
G Sayami
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Diagnostic Yield ◽  
Sampling Technique ◽  
Needle Aspiration ◽  
Small Cell ◽  
Sampling Techniques ◽  
Transbronchial Needle Aspiration ◽  
Negative Results ◽  
Diagnosis Of Lung Cancer

Background: Negative results in bronchoscopic sampling techniques increase costs and delay treatment. We analyzed if addition of transbronchial needle aspiration (TBNA) increases the diagnostic yield of bronchoscopy. Materials and Methods: Patients with endobronchial abnormalities in whom a full set of sampling techniques (lavage, TBNA, biopsy and brushing) were done and had a confirmed diagnosis of lung cancer by one or more methods were included. The positivity rates of each of the sampling techniques and their various combinations were studied. We compared the positivity rates of bronchoscopy with and without TBNA. We also studied if TBNA was more valuable in any specific type, histology or position of endobronchial abnormalities. Results: The overall positivity rate of TBNA was 56%. It was higher than lavage and brushing but lower than biopsy. The addition of TBNA to the routine combination of sampling tachniques (lavage, biopsy and brushing) increased diagnostic yield from 76% to 86.6%. Contrary to previous reports, the increase in diagnostic yields did not differ significantly between types (exophytic vs submucosal), side or location of the endobronchial lesions. TBNA was found to have a significantly better positivity rates in small cell carcinoma than in non-small cell carcinoma cases. Conclusion: TBNA is a safe sampling technique for endobronchial abnormalities during bronchoscopy. It increases the diagnostic yields of bronchoscopy and this increase seems to be uniform amongst different types, histologies and locations of endobronchial abnormalities. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10324 Journal of Pathology of Nepal (2014) Vol. 4, 565-569

scholarly journals Lung Cancer in a Tertiary Hospital in Nepal: Clinical-Radiological Profile and Histological Subtypes

2020 ◽  
Vol 17 (4) ◽  
pp. 463-467
Author(s):  
Ashesh Dhungana ◽  
Devendra Bhattarai ◽  
Prajowl Shrestha ◽  
Niranjan Acharya
Keyword(s):  
Lung Cancer ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Tertiary Hospital ◽  
Small Cell ◽  
Histological Subtypes ◽  
Bronchial Wash ◽  
Diagnosis Of Lung Cancer

Background: Lung cancer is the most common cancer worldwide and in Nepal. Non small cell carcinoma is the commoner histological type. The incidence of adenocarcinoma subtype is increasing globally. This study aims to evaluate the clinical-radiological and histological profile and the diagnostic yield of various modalities in the diagnosis of lung cancer at a tertiary hospital in Nepal.Methods: This is a prospective cross-sectional study conducted at National Academy of Medical Sciences, Kathmandu. Patients presenting with clinical and radiological features consistent with lung cancer and undergoing tissue sampling were included. The clinical and radiological characteristics, distribution of various histological subtypes and the diagnostic yield of various modalities were evaluated.Results: Of the 253 patients screened, 77 meeting the inclusion criteria were enrolled into the study. Lung cancer was diagnosed in 53 patients. Forty (75.5%) patients had non small cell carcinoma and 13 (24.5%) had small cell carcinoma. Among the non small cell variants, 20 (37.7%) had adenocarcinoma and 19 (35.9%) had squamous cell carcinoma. Hitopathological diagnosis of lung cancer was established in 39 of the 42 (92.9%) patients by bronchoscopy. Image guided biopsy and/or aspiration yielded the diagnosis in 13 (24.5%) patients. The diagnostic yields of endobronchial biopsy, needle aspiration, bronchial brush and bronchial wash cytology were 86.5%, 70%, 63% and 34.3%respectively. Conclusions: The result of this study concurs with the global trend of rising incidence of adenocarcinoma subtype. Bronchoscopy remains the most commonly used tool for diagnosis of lung cancer and combination of procedures such as biopsy, bronchial brush, needle aspiration and bronchial wash provided the highest yield in our study.Keywords: Bronchoscopy, Histological subtypes, Lung cancer, Tertiary hospital, Nepal.

scholarly journals Lung cancer: 1 year experience at tertiary care centre with reference to cytodiagnostic approach

2017 ◽  
Vol 4 (1) ◽  
pp. 133
Author(s):  
Mansi Mehta ◽  
Nisha Gupta ◽  
Jaydeep Odhwani ◽  
Nandini Desai ◽  
P. M. Santwani
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Brush Cytology ◽  
Fine Needle ◽  
Bronchial Washing ◽  
Diagnosis Of Lung Cancer

Background: Lung cancer is the most common cancer incidence wise as well as leading cause of cancer related death in worldwide as well as in India. Cytological diagnosis plays an important role in patients having lung cancer. This study was conducted to evaluate sensitivity of various cytological methods in diagnosis of lung cancer, to study typing of lung cancer, age and gender wise distribution of lung cancer and its association with smoking.Methods: This study includes patients having clinical and radiological diagnosis of lung cancer. Total 150 cases of entire January 2015 to December 2015 are included. Methods obtaining samples includes, abrasive cytology by bronchoscope guided: bronchoalveolar lavage (BAL); brush cytology and bronchial washing, CT/USG guided transthoracic fine needle aspiration, trans- bronchial needle aspiration. Samples have been processed as per standard protocols and cytomorphology of samples are studied, along with these patient age, gender, and smoking habit have been recorded.Results: Sensitivity of various method: abrasive cytology by bronchoscope guided bronchoalveolar lavage (BAL); brush cytology and bronchial washing, trance bronchial needle aspiration, CT/USG guided transthoracic fine needle aspiration is 70%, 66%, 90% respectively. Adenocarcinoma is most common carcinoma followed by squamous carcinoma, having incident of 41%, 31.39% respectively. In male patient peak age is 5th decade, and in female peak age is 6th decade. Male:female ratio is 5.1:1. Adenocarcinoma is most common carcinoma is 10 times more common in non-smokers as compare to squamous cell carcinoma .But association of squamous cell carcinoma with smoking is 97%.Conclusions: CT/USG guided transthoracic fine needle aspiration method has highest sensitivity. In male patients peak age of presentation of lung carcinoma is 5th decade, and in female patient’s peak age is 6th decade. Lung carcinoma found to be more common in males than in females. Adenocarcinoma is most common carcinoma. It is 10 times more common in non-smokers as compare to squamous cell carcinoma. Association of squamous cell carcinoma with smoking is 97%.

scholarly journals Diagnosis of Hodgkin Lymphoma from Cell Block: A Reliable and Helpful Tool in “Selected” Diagnostic Practice

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 748
Author(s):  
Paola Parente ◽  
Claudia Covelli ◽  
Magda Zanelli ◽  
Domenico Trombetta ◽  
Illuminato Carosi ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Cell Block ◽  
Ultrasound Guided ◽  
Block Method ◽  
Molecular Analyses ◽  
Fine Needle ◽  
Conventional Cytology ◽  
Morphological Evaluation

Background: The diagnosis of lymphoma requires surgical specimens to perform morphological evaluation, immunohistochemical and molecular analyses. Ultrasound-guided fine needle aspiration may represent an appropriate first approach to obtain cytological samples in impalpable lesions and/or in patients unsuitable for surgical procedures. Although cytology has intrinsic limitations, the cell block method may increase the possibility of achieving an accurate diagnosis. Methods: We retrospectively selected a total of 47 ultrasound-guided fine needle aspiration and drainage samples taken from patients with effusion and deep-seated lesions which are clinically suspicious in terms of malignancy. Results: In 27 cases, both cell block and conventional cytology were performed: 21/27 cell blocks were adequate for the diagnosis of lymphoma and suitable for immunocytochemistry and molecular analyses vs. 12/20 samples to which only conventional cytology was applied. Moreover, in five patients we were able to make a diagnosis of Hodgkin lymphoma with the cell block (CB) technique. Conclusions: Contrary to conventional cytology, the cell block method may allow immunocytochemistry and molecular studies providing useful information for the diagnosis and subtypization of lymphoma in patients unsuitable for surgical procedure or with deep-seated lesions or extra-nodal diseases; additionally, it is a daily, simple and helpful approach. Moreover, we describe the usefulness of cell blocks in the diagnosis of Hodgkin lymphoma.

scholarly journals Diagnostic efficacy cell block method of transthoracic fine needle aspiration in diagnosis of lung cancer

2021 ◽  
Vol 40 (2) ◽  
pp. 133-140
Author(s):  
Yusup Subagio Sutanto ◽  
Nur Santi ◽  
Brian Wasita ◽  
Ana Rima ◽  
Hendra Kurniawan
Keyword(s):  
Lung Cancer ◽  
Sensitivity And Specificity ◽  
Cancer Diagnosis ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Cell Block ◽  
Fine Needle ◽  
Lung Cancer Diagnosis ◽  
Bronchial Washing ◽  
Diagnosis Of Lung Cancer

BackgroundLung cancer is still the main cause of cancer deaths. The high lung cancer mortality rate is caused by a diagnosis factor or therapy selection. The cell block cytology technique using fine needle aspiration (FNA) samples can provide immunocytochemical material that plays an important role in the differential diagnosis of lung cancer subtypes and in determining immunotherapy administration. This study aimed to determine the sensitivity and specificity of transthoracic FNA (TTFNA) cell block cytology in comparison with bronchial washing smears and TTFNA smears in diagnosing lung cancer. MethodsThis was a cross-sectional diagnostic study involving 26 subjects. All subjects had undergone bronchial washing and CT scan-guided fine needle aspiration followed by cell block preparation. Both direct FNA smears and cell blocks are useful in the diagnostic work-up of patients. Comparative statistical analysis of TTFNA cell block versus bronchial washing smear and TTFNA smear cytology was carried out using the McNemar test. ResultsLung cancer was found in 15 patients (57.7%) using the TTFNA cell block technique. The sensitivity and specificity of the TTFNA cell block technique were 85.7% and 75%, respectively. There was no difference in the positivity value between TTFNA cell block technique of bronchial wash smear technique, and TTFNA smear on lung cancer diagnosis (p>0.05). ConclusionsTransthoracic fine-needle aspiration in combination with the cell block technique has good sensitivity and specificity. The TTFNA can be used for immunocytochemical examinations in lung cancer diagnosis and therapy. This approach is valuable for providing individualized treatment and prognostic evaluations.

Preparation technique for cytologic study of EUS-guided FNA samples when onsite cytopathologist is absent: Cell block, smear, or both?

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 176-176
Author(s):  
N. Q. Nguyen ◽  
K. Lim ◽  
A. Ruszkiewicz
Keyword(s):  
Direct Relationship ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Preparation Technique ◽  
Cell Block ◽  
Solid Mass ◽  
Ancillary Studies ◽  
Tissue Material ◽  
Adequate Tissue ◽  
Cytologic Study

176 Background: Smearing EUS-guided fine-needle aspiration (FNA) samples, with or without cell block, is most commonly performed for cytologic study in centers without onsite cytology. The diagnostic yield of such technique is often low (35%-50%) and may be related to loss of diagnostic material during the smearing process. Cell block technique captures not only aspirated cells but also small tissue fragments, improving diagnostic yield and enabling additional ancillary studies. This study aimed to compare the diagnostic yield of cell block alone against conventional smear (±cell block) technique in the EUS-guided FNA evaluation of pancreatic solid mass without onsite cytological assessment. Methods: Data on the diagnostic yield of cell block alone technique performed over the last 12 months were prospectively collected and were compared to the yield of conventional smear ± cell block technique. A positive diagnostic yield was defined by the presence of adenocarcinoma and/or FNA findings consistent with the final surgical diagnosis. Results: Data were available for 96 patients, of which 66 had cell block alone and 30 had smear +/-cell block preparation. The diagnostic yield of cell block alone was significantly higher that that of smear +/- cell block (53/66 vs 13/30; P=0.003). The addition of cell block after smearing did not improve the diagnostic yield (smear: 42% vs. both: 45%, p=0.88). Of patients who had smear +/-cell block, the diagnostic yield was significantly higher when the smearing was performed by cytopathologist as compared to that by nurse (10/16 vs. 3/14, p=0.02). There was a direct relationship between the rate of diagnostic yield and the number of FNA passes performed. The yield was highest when 4 or more FNA passes was performed (85%) as compared to that of 3 passes (63%, p=0.049) and 2 or less passes (38%, p<0.0001). Conclusions: In the absence of onsite cytology services, the diagnostic yield from cell block alone was high (80%) and was superior to smear technique whether cell block was added to the evaluation of smears. In order to obtain adequate tissue material to maximise the diagnostic yield EUS-guided FNA of pancreatic mass, at least 4 FNA passes should be performed. No significant financial relationships to disclose.

scholarly journals Diagnostic yield and agreement on fine-needle specimens from solid pancreatic lesions: comparing the smear technique to liquid-based cytology

2020 ◽  
Vol 08 (02) ◽  
pp. E155-E162 ◽  
Author(s):  
Priscilla A. van Riet ◽  
Rutger Quispel ◽  
Djuna L. Cahen ◽  
Mieke C. Snijders-Kruisbergen ◽  
Petri van Loenen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Yield ◽  
Diagnostic Value ◽  
Needle Aspiration ◽  
Cell Block ◽  
Pancreatic Lesion ◽  
Fine Needle ◽  
Site Evaluation ◽  
Liquid Based Cytology ◽  
Solid Lesions

Abstract Background and study aims The traditional “smear technique” for processing and assessing endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is sensitive to artifacts. Processing and evaluation of specimens collected in a liquid medium, liquid-based cytology (LBC) may be a solution. We compared the diagnostic value of EUS-FNA smears to LBC in pancreatic solid lesions in the absence of rapid on-site evaluation (ROSE). Patients and methods Consecutive patients who required EUS-FNA of a solid pancreatic lesion were included in seven hospitals in the Netherlands and followed for at least 12 months. Specimens from the first pass were split into two smears and a vial for LBC (using ThinPrep and/or Cell block). Smear and LBC were compared in terms of diagnostic accuracy for malignancy, sample quality, and diagnostic agreement between three cytopathologists. Results Diagnostic accuracy for malignancy was higher for LBC (82 % (58/71)) than for smear (66 % (47/71), P = 0.04), but did not differ when smears were compared to ThinPrep (71 % (30/42), P = 0.56) or Cell block (62 % (39/63), P = 0.61) individually. Artifacts were less often present in ThinPrep (57 % (24/42), P = 0.02) or Cell block samples (40 % (25/63), P < 0.001) than smears (76 % (54/71)). Agreement on malignancy was equally good for smears and LBC (ĸ = 0.71 versus ĸ = 0.70, P = 0.98), but lower for ThinPrep (ĸ = 0.26, P = 0.01) than smears. Conclusion After a single pass, LBC provides higher diagnostic accuracy than the conventional smear technique for EUS-FNA of solid pancreatic lesions in the absence of ROSE. Therefore, LBC, may be an alternative to the conventional smear technique, especially in centers lacking ROSE.

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