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. 2019 Apr 22:16:8.
doi: 10.4103/cytojournal.cytojournal_19_18. eCollection 2019.

Subtyping of non-small cell lung cancer by cytology specimens: A proposal for resource-poor hospitals

Betul Celik  1   2 , Tangul Bulut  2 , Andras Khoor  1
Affiliations

Subtyping of non-small cell lung cancer by cytology specimens: A proposal for resource-poor hospitals

Betul Celik et al. Cytojournal. .

Abstract

Aim: Cancer diagnosis and treatment depend on pathology reports but naming a cancer is sometimes impossible without specialized techniques. We aimed to evaluate the sensitivity of cytological sub-classification of non-small cell lung carcinoma, not otherwise specified group (NSCLC-NOS) into Adenocarcinoma (AC) and Squamous cell carcinoma (SqCC) without using immunohistochemistry.

Methods: Endobronchial ultrasound guided fine-needle aspiration biopsies and cytology slides diagnosed as NSCLC-NOS between 2004- 2008 were reviewed retrospectively. The final diagnosis was reached by immunohistochemistry (TTF-1, p63) when necessary.

Results: One hundred-twenty nine cases were retrieved. The final diagnoses were as follows: SqCC: 30.3%; AC: 65.7%; combined tumor (3 adenosquamous and 1 small cell + SqCC): 4%. Cytological diagnoses rendered were as follow: Definitely SqCC: 10.1%; favor SqCC: 14.1%; definitely AC: 38.4%; favor AC: 35.4%; NSCLC-NOS: 2%. The sensitivity and specificity of cytology were 86.3 and 87.5% for AC diagnosis respectively.

Conclusion: Positive and negative predictive value of cytology was 95.3% and it was even 100% for well to moderately differentiated tumors. There was a tendency to sub-classify poorly differentiated SqCC as AC. Papanicolaou stain increased the diagnostic accuracy of SqCC. The combined tumor rate was 4% and after recognizing a tumor component, the second component was missed if the slide examination was terminated prematurely.

Keywords: Cytology; lung carcinoma; non-small cell lung carcinoma; poor-resource yes; resource-poor is better; sub-classification.

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Figures

Figure 1
Figure 1
The cell group that tends to form a lumen. Polarity by pushing the nucleus to one edge is easily appreciated (Giemsa, ×20). Intranuclear cytoplasmic curve typical for adenocarcinoma (Giemsa, ×40)
Figure 2
Figure 2
(a) Keratinized cell, PAP, ×20 (b) tad-pole cell. This cell seen as stretching of cytoplasm is typical for squamous cell carcinoma (Giemsa, ×40)
Figure 3
Figure 3
Cytoplasmic eosinophilia, typical for squamous cell carcinoma (PAP, ×20)
Figure 4
Figure 4
An example of suboptimal slides. The details of the cell group cannot be distinguished (Giemsa, ×20)
See this image and copyright information in PMC

References

    1. Ecka RS, Sharma M. Rapid on-site evaluation of EUS-FNA by cytopathologist: An experience of a tertiary hospital. Diagn Cytopathol. 2013;41:1075–80. - PubMed
    1. Hu Y, Puri V, Crabtree TD, Kreisel D, Krupnick AS, Patterson AG, et al. Attaining proficiency with endobronchial ultrasound-guided transbronchial needle aspiration. J Thorac Cardiovasc Surg. 2013;146:1387–920. - PMC - PubMed
    1. Harris CL, Toloza EM, Klapman JB, Vignesh S, Rodriguez K, Kaszuba FJ. Minimally invasive mediastinal staging of non-small-cell lung cancer: Emphasis on ultrasonography-guided fine-needle aspiration. Cancer Control. 2014;21:15–20. - PubMed
    1. Dong X, Qiu X, Liu Q, Jia J. Endobronchial ultrasound-guided transbronchial needle aspiration in the mediastinal staging of non-small cell lung cancer: A meta-analysis. Ann Thorac Surg. 2013;96:1502–7. - PubMed
    1. Raptakis T, Boura P, Tsimpoukis S, Gkiozos I, Syrigos KN. Endoscopic and endobronchial ultrasound-guided needle aspiration in the mediastinal staging of non-small cell lung cancer. Anticancer Res. 2013;33:2369–76. - PubMed