Comparison of liquid-based preparation and conventional smear of fine-needle aspiration cytology of lymph node

Abstract

Background: In this paper, we have compared the cytomorphologic characteristics of liquid-based preparation (LBP) [SurePath (SP)] cytology and conventional smear (CP) preparations on fine-needle aspiration (FNAC) material by a semi-quantitative scoring system for cases of lymphadenopathy.

Materials and methods: In this prospective study, a total of 52 consecutive cases of FNAC of lymphadenopathy were included. The first pass was used for CP followed by LBP with the help of SP technique. The smears were independently compared and assessed by two observers (PS and PD).

Results: The semiquantitative grading was compared in two groups by Wilcoxon signed-rank test. The background information, cell architecture, pleomorphism, nuclear and cytoplasmic details, and three-dimensional structures were significantly different in LBP and CP smears.

Conclusions: Liquid-based cytology (LBC) is a relatively simple technique, which exhibits good nuclear and cytoplasmic details with the absence of obscuring background material. Even the number of slides and area per slide to be screened were less than the conventional preparation but caution must be applied to interpret the slides and secure a diagnosis, especially if LBC is the first and only method applied for diagnosis.

Keywords: Fine-needle aspiration cytology (FNAC); SurePath (SP); liquid-based cytology (LBC).

Figure 1

(a) Conventional smear of metastatic squamous cell carcinoma in the cervical lymph node showing cells in clusters (H&E stain, ×440) (b) LBP of the same case showing predominantly singly scattered cells ((Pap stain, ×440)

Figure 2

(a) Conventional smear showing scattered atypical cells in a case of Lymphnode showing infiltration by Mycosis Fungoides. (H&E stain, ×1200) (b) LBP of the same showing scattered atypical cells and reactive lymphoid cells with eccentric cytoplasmic projections. (Pap stain, ×1200) (c) Conventional smear of Langerhans cell histiocytosis showing characteristic nuclear grooving (H&E stain, ×1200) (d) LBP of the same showing less defined nuclear details. (Pap stain, ×1200)

Figure 3

(a) Conventional preparation smear showing granuloma in case of tubercular lymphadenitis. [(H&E stain, ×440) (b) LBP smear of the same (Pap stain, ×440)