Comparison of ThinPrep and cytospin preparations in the evaluation of exfoliative cytology specimens.
BACKGROUND
There exists limited literature comparing ThinPrep (TP) with conventional cytospins (CS) in nongynecologic specimens.


METHODS
The differences between TP and CS were evaluated for a variety of parameters including cellularity, cytologic morphology, specimen preparation, screening time, laboratory cost effectiveness, cytologist preference, and impact on final diagnosis. Eighty-eight cases including 38 urine, 13 respiratory, and 37 body fluids were prepared simultaneously.


RESULTS
TP and CS demonstrated similar cellular yield in the majority of cases. Cytologists preferred TP in 63 (71.6%) and CS in 6 (6.8%) cases; whereas they indicated no preference in 19 (21.6%) cases. Of 14 abnormal cytologies, a more definitive diagnosis of malignancy was rendered by TP in 6 (42.9%) and by CS in 2 (14.3%) cases. TP demonstrated better nuclear chromatin morphology and more uniform distribution of cells. CS showed larger-sized clusters with better preservation of their architecture compared with smaller-sized clusters and significant shrinkage of cell size in TP.


CONCLUSIONS
TP was preferred over CS in the majority of cases by both cytotechnologists and pathologists. Cellularity, screening time, and specimen preparation were comparable, although the latter was easier to standardize in TP. In abnormal cases, TP was found to be 3 times more helpful than CS in rendering a definitive diagnosis of malignancy. TP, however, was associated with certain artifacts that cytologists must become familiar with when examining such preparations. Although TP was superior to CS in most cases, the application of both methods may be helpful in selected cases in which the TP diagnosis is not conclusive. Finally, TP was found to be more cost effective than CS.
Elsheikh
Tarik M
TM
Pathologists Associated, Ball Memorial Hospital, Muncie, Indiana 47303, USA. elsheikht@palab.com
Kirkpatrick
Joseph L
JL
Wu
Howard H
HH
D000230:Adenocarcinoma / Q000175:diagnosis; D000368:Aged; D000369:Aged, 80 and over; D001826:Body Fluids / Q000378:metabolism*; D002277:Carcinoma / Q000175:diagnosis*; D018288:Carcinoma, Small Cell / Q000175:diagnosis; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D014571:Urologic Neoplasms / Q000175:diagnosis*