title: The evaluation of liquid-based 'Cyto-SED' cytology of bronchioalveolar lavage specimens in the diagnosis of pulmonary neoplasia against conventional direct smears.
abstract: Historically, bronchioalveolar lavage (BAL) samples have been prepared by a direct smear (DS) technique. Recent advances in liquid-based cytology have led to a revolution in cytological specimen preparation. Cyto-SED system (CS) is a manual liquid-based cytology system, designed for small-scale use. A total of 137 samples from patients with radiographically detectable lesions underwent BAL procedures at Papworth Hospital NHS Trust over a 4-month period. After preparation for diagnostic purposes with the DS method, the remaining sample was prepared using the CS system. The slides produced were allocated a blind study number and screened by three independent screeners. The cellular morphology was well preserved and comparable between both techniques. Of the 137 patients, 38% were confirmed as malignant by cytology or histology; 71% of these malignant diagnosis were confirmed by the DS technique and 91% confirmed by the CS. The results demonstrate that the CS is a viable alternative to the DS technique. The cytological detail is clearly defined without a loss of three-dimensional information, thus aiding the differential diagnosis of malignancy. Cyto-SED cytology system yields a higher diagnostic accuracy than the conventional direct smear technique without compromising on cytological detail.
authors.affiliation: Department of Pathology, Papworth Hospital, Papworth Everard, Cambridge, UK.
authors.forename: E
authors.initials: E
authors.lastname: Astall
authors.forename: C
authors.initials: C
authors.lastname: Atkinson
authors.forename: N
authors.initials: N
authors.lastname: Morton
authors.forename: M J
authors.initials: MJ
authors.lastname: Goddard
mesh_terms: D018893:Bronchoalveolar Lavage; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D016591:Histocytological Preparation Techniques / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity