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. 2014 Oct-Dec;31(4):189-93.
doi: 10.4103/0970-9371.151128.

Role of rapid on-site evaluation with cyto-histopathological correlation in diagnosis of lung lesion

Smita Chandra  1 , Harish Chandra  1 , Girish Sindhwani  2
Affiliations

Role of rapid on-site evaluation with cyto-histopathological correlation in diagnosis of lung lesion

Smita Chandra et al. J Cytol. 2014 Oct-Dec.

Abstract

Aim: This study was conducted to assess the role of cytology in the diagnosis of lung lesions and to compare it with histopathology. It was also intended to evaluate the role of rapid on site evaluation (ROSE) as an adjunct to cytological diagnosis of lung lesions.

Materials and methods: The study included all the cases of lung lesions, which were diagnosed on cytology followed by histopathology over a period of 2½ years along with ROSE, wherever possible.

Results: Cytology was done in total 782 cases of various lung lesions and of this cyto-histopathological correlation was available in 215 cases. ROSE was done in 93.4% of total cases and smears were considered on the site adequate in the first pass in 68.1% cases and in second pass adequacy increased to 93.4%. The diagnostic accuracy of cytology was 75.3%, and that of histology was 86.9% in the diagnosis of lung lesions. The diagnostic accuracy of cytology for squamous cell carcinoma (94.4%) and adenocarcinoma (96.5%) was higher than that of histology.

Conclusion: Cytology is comparable to histology in the diagnosis of lung lesions and may even outperform biopsy in lung tumor diagnosis. The advantages of cytology may be further added by better sampling and preanalytical assessment for adequate diagnostic material and ROSE has proved to be an important, easy and cost effective adjunct in this regard. A multidisciplinary approach involving pulmonologist, radiologist and cytopathologist with ROSE, followed by vigilant morphological examination may increase diagnostic utility of cytology for lung lesions.

Keywords: Cytology; cyto-histopathological correlation; histology; lung lesions; rapid on site evaluation.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Bar chart showing different cytological methods used for obtaining cytological material for diagnosis of lung lesions
Figure 2
Figure 2
(a) Papillaroid fragment of adenocarcinoma on rapid on site evaluation on (ROSE) (toluidine blue, ×100) (b) Squamous cell carcinoma on ROSE (toluidine blue, ×100)
Figure 3
Figure 3
(a) Bronchial biopsy showed only necrosis and was inadequate for diagnosis (H and E, ×40) (b) same case on transbronchial needle aspirate cytology smears showed presence of cellular tumor fragments of primitive neuroectodermal tumor (PNET) (MGG, ×100) (c) Round cells showing nuclei with stippled chromatin and moderate pale cytoplasm in PNET were well appreciated on higher resolution on (Pap, ×400)
Figure 4
Figure 4
(a) Crush artifact on bronchial biopsy, inadequate for diagnosis (H and E, ×100) (b and c) same case on computed tomography guided fine needle aspiration on cytology smears show small cell carcinoma with evidence of nuclear moulding (b, H and E, ×100; c, MGG, ×400)
See this image and copyright information in PMC

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