[354] The Diagnostic Value of Cell Block from Liquid-Based Bronchial Washings Cytology Specimens in the Diagnosis and Subclassification of Pulmonary Neoplasms.

George Collins, Songlin Zhang, Jaiyeola Thomas. Louisiana State University Health Sciences Center-Shreveport, Shreveport

Background: Though cell block (CB) preparations of bronchial washings cytology specimens are routinely done in our institution, its diagnostic value has received little attention in the literature. The diagnostic value of routine CB as adjunct to liquid based (ThinPrep) bronchial washing cytology preparations (LBC) in the detection and subclassification of pulmonary neoplasms has not been evaluated. This study aims to evaluate the diagnostic utility of CB in this setting.
Design: This study included all 74 bronchial washings samples and CB diagnosed as malignant or suspicious/atypical from bronchoscopies done in our institution during 2009. 28 randomly selected negative cases were also reviewed. The LBC and CB preparations were reviewed independently. Deeper levels, ancillary stains, and PCR analysis were done on CB when necessary for specific classification of tumors. LBC and CB diagnoses were compared and correlated with final histology/bronchial brushing diagnoses.
Results: LBC and CB yielded adequate material for diagnosis in all cases. Table 1 shows the correlation of CB and LBC diagnoses.

Table 1: Comparison of LBC and Cell Block Diagnoses
LBC diagnosis (# of cases)Cell Block diagnosis (# of cases)
 Positive (29)Suspicious (9)Atypical( 26)Negative (38)
Positive (18)11250
Atypical (41)102209
Negative (30)11028

The use of cell blocks increased the number of positive malignant diagnoses from 18 (with LBC diagnosis only) to 36, with an increase in diagnostic yield of 100 %. CB detected more malignant neoplasms (29) than did LBC (18). Specific tumor diagnosis was possible in 22/29 (76%) malignancies detected by CB compared with 12/18 (67%) detected by LBC. Bronchial brushings done in 35/36 (97%) malignant cases confirmed malignancy in 32 cases. Similarly, histology confirmed malignancy in 33/36 (92%) cases.
Conclusions: The use of CB preparation significantly improved diagnostic yield in this study. In addition, specific diagnosis of tumor type was often possible, and material was available for immunohistochemical and molecular studies when necessary. In summary, the use of CB on bronchial washings as an adjunct to LBC is useful in the diagnosis of pulmonary neoplasms especially in LBC suspicious and atypical diagnostic categories.
Category: Cytopathology

Tuesday, March 1, 2011 9:30 AM

Poster Session III # 78, Tuesday Morning


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