Conventional versus Liquid-based Cytology: "Man versus Machine".

Background: Liquid-based cytology (LBC) can improve adequacy, monolayer quality with a clean background compared to conventional smears (CS). Aims and Objectives: The objective was to compare the quality and diagnostic yield of CS and LBC in routine cytological investigations. Materials and Methods: This retrospective study consisted of 306 samples (255 gynecological, 39 nongynecological, and 12 fine needle aspiration cytology [FNAC]) during a 2-year period (2019-2020). From each patient, two samples were collected in the same manner in the same sitting and processed by CS and LBC (ThinPrep® 2000, Hologic Inc.). Both CS and LBC were compared for adequacy, quality, representativeness, inflammation, hemorrhage, necrosis, preservation, reactive changes, organisms, atypia/dysplasia/malignancy, and preparation/screening time. Statistical analysis was performed. Results: No statistically significant difference was noted for adequacy, representativeness, reactive changes, preservation, and atypia/dysplasia/malignancy. CS was better in cellularity and diagnosis of inflammation and organisms, whereas LBC had a clean background and the difference was statistically significant (P = 0.0005). Conclusions: CS was equivalent to LBC in adequacy, representativeness, reactive changes, and atypia/dysplasia/malignancy. Adequacy comparable to LBC can be achieved in CS by careful sample collection, processing, and screening by trained cytotechnologists. CS was better in detecting organisms and inflammation than LBC. The advantages of LBC were monolayer smear, clean background, and lesser screening time, but the demerit was higher cost and longer processing time. Therefore, LBC is best suited to those laboratories having high sample inadequacy rates, lack of competent cytotechnologists, and no financial constraints. Either man or machine, appropriate and adequate sample collection by trained personnel forms the cornerstone for ensuring adequacy in both CS and LBC.

Diagnosis of hidradenoma papilliferum of the vulva on cytologic smears: a case report.

BACKGROUND: Hidradenoma papilliferum is a rare benign tumor of the vulva that occurs mainly in women in the skin of the anogenital region. Clinically it may mimic a carcinoma, so the correct cytologic interpretation of the tumor cells with subsequent careful histologic confirmation is essential for good management. CASE: A 44-year-old woman who had a history of hysterectomy 14 years earlier presented with a small, exophytic growth on the labia majora. Fine needle aspiration cytology and vulvar scraping of the lesion were reported as a malignant tumor, and the case was referred to our center for further management. Repeat vulvar smears showed mainly groups and clusters of benign-looking glandular cells and were interpreted as a benign tumor. Subsequent histology confirmed the diagnosis of hidradenoma papilliferum. CONCLUSION: This case highlights the cytologic features of hidradenoma papilliferum on cytologic smears. The clinical presentation should not mislead the cytologic interpretation of the tumor cells.

Is the Morning Sputum Sample Superior to the Fresh Sputum Sample for the Detection of Malignant Cells?

INTRODUCTION: Sputum cytology is a well-established technique for the detection of lung malignancies. Generally, random or morning samples are used. OBJECTIVES: To evaluate the diagnostic yield of morning sputum and compare it with that of fresh samples. MATERIALS AND METHODS: Patients were instructed to bring a morning sputum sample to the laboratory in a clean plastic container, without any fixative and within 2-3 h of collection. Fresh sputum was then collected in the laboratory from these same patients. Two smears were prepared from each sample by the "pick and smear" technique and then stained by the Papanicolaou method. One hundred samples from each method (total 200 samples; 400 slides) were evaluated by 3 investigators for their adequacy, preservation, and yield of diagnostic cells. The results were analyzed by using the Pearson χ2 test. RESULTS: Cytomorphological details were preserved in 82/84 satisfactory morning samples and in 80/81 satisfactory fresh samples, respectively. Malignancy was detected in 37 morning samples (44%) and 25 fresh samples (30.8%). In the malignant samples, there were more abundant tumor cells in the morning samples than in the fresh samples (65 and 40%, respectively) with a 2+ cellularity in the morning samples. The morning samples showed a better cell yield (25% more), with a 13% increase in the rate of detection of malignancy and an increased sensitivity of 19.68% compared to the fresh samples. CONCLUSIONS: Adequacy and preservation was similar in both sample types. While the morning samples showed a higher sensitivity and a larger number of tumor cells than the fresh samples, the difference was not statistically significant (p < 0.054).