Rapid Cytodiagnosis By Different Staining Techniques In Comparison With Conventional Stains In Thyroid Cytology
Keywords:
Toludine blue wet mount, Methylene/Eosin, Rapid cytodiagnosis, Quality index
Abstract
BACKGROUND:Fine needle aspiration cytology (FNAC) is a very important component of pre-operative / pre-treatment investigation in combination with clinical, radiological and other laboratory data. In spite of its advances and advantages, conventional FNAC fails to achieve a 100% accuracy. To improve the accuracy of FNAC, a supravital stained Toluidine blue wet mount (TBWM) preparation of the aspirate and Methylene blue/Eosin (M/E) stained smears are studied which will give additional information regarding the lesion on which FNAC is done.OBJECTIVE:To assess the diagnostic rapidity of the Toluidine blue wet mount preparation and Methylene blue/Eosin stain in FNAC and to compare the morphological features and results obtained from rapid stains with conventional PAP and H&E techniques in FNAC.METHODS:The study was conducted on Fine needle aspirates from 100 patients presenting with thyroid swelling in R.L Jalappa hospital attached to Sri DevarajUrs Medical College, Kolar, Karnataka. TBWM, M/E stain, H&E stain and Pap stain was done for all 100 cases. Time taken for each stain is assessed and the morphology of rapid stains were compared with the conventional stain. Quality index was calculated for all the stains.RESULTS:The rapidity of the stains was assessed for all four stains. Toluidine blue wet mount takes only 2 minutes for staining followed by Methylene blue/eosin which takes 5 minutes. M/E stain gave the same result as compared to the conventional stains [PAP and H&E]. In TBWM there was difficulty in diagnosing few cases due to three dimensional clusters. The sensitivity and specificity of TBWM were 66% and 90% whereas for M/E stain 98% and 100%. The quality index of PAP stain, H&E stain, M/E stain and TBWM were 0.85, 0.81, 0.71, 0.660.66.CONCLUSION:Thus, both stains can be routinely undertaken as a supplementary procedure for conventional stains to improve the cellularity and to reduce the time taken for re-sampling.DOI: 10.21276/APALM.1621References
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5.Idris AAA, Hussain MS. Comparison of the efficacy of three stains used for the detection of cytological changes in Sudanese females with breast lumps. Sudanese J Pub Health 2009;4:275-77.
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8.Verma K, Tiwari MC, Agarwal J, Kapila K. Diagnostic accuracy of immediate interpretation of fine needle aspiration. Indian J Med Res 1991;94:197-199.
9.Chang MC, Chan RD, Ho WL. Intra operative cytology, the use of Liu’s stain for immediate diagnosis. Zhonghua Yi XueZaZhi (Taipei) 1993;51:368-375.
10.Yang GC, Alvaraz ll. Ultra fastpapanicolaou stain. An alternative preparation for fine needle aspiration cytology. ActaCytol1995;39:55-60.
11.Tsou MH, Lin HH, Ko JS. Riu’s Stain and the cytologic diagnosis of thyroid fine needle aspiration a single cancer center experience. DiagnCytopathol1997;16:543-547.
12.Caya JG, Clower LJ, Wollenberg NJ, Tiev TM. Transthoracoc fine needle aspiration cytology, Analysis of 82 patients with detailed verification criteria and evaluation of false negative cases. Am J ClinPathol1984;82:100-103.
13.Winning AJ, Seed MJ, Husain WA, Metaxas OAN. Interpretation of Negative results in fine needle aspiration of discrete pulmonary lesions. Thorax 1986;41:875-9.
14.Cagle PT, Kovach M. Ramzy I. Causes of false results in transthoracic fine needle aspirates. ActaCytol1993;37:16-20.
15.David J, Henry CK, Feider, Splittgerber GF. Toluidine blue dye as a breast localization marker. Am J Roentqenol1989;153:261-263.
16.Dudgeon LS, Patrick CV. A new method for the rapid microscopical diagnosis of tumors. Br J Surg1927;15:250-261.
17.Orell SR. Fine needle aspiration cytology. 5th ed. New Delhi: Elsevier; 2013.
2.Sumathy C, Durai SJ, Swaminathan K, Vallimanalan S, Munavarah SA. Supravital stained rapid wet mount preparation of fine needle aspirates-A cytomorphological study. TEJMS 2012;3:62-66.
3.Joy MP, Iyer VK, Aron M, Kapila K, Verma K. Rapid staining using toluidine blue: A reliable method for quick diagnosis in ultrasound guided aspiration cytology. Indian J PatholMicrobiol 2003;46:589-92.
4.Erkilic S, Kocer NE. Diagnostic accuracy of toluidine blue stained wet films in effusion cytology. ActaCytol 2006;50:407-9.
5.Idris AAA, Hussain MS. Comparison of the efficacy of three stains used for the detection of cytological changes in Sudanese females with breast lumps. Sudanese J Pub Health 2009;4:275-77.
6.Foot CN, Nelson D, Quist H. Supravital staining of sediments of serous effusions, a simple technique for Rapid Cytological diagnosis. Cancer 1958;11:151-157.
7.Silverman JF, Finley JL, O’Brien KF, Dabbs DJ, Park HK, Larkin EW, et al. Diagnostic accuracy and role of immediate interpretation of fine needle aspiration biopsy specimen from various sites. ActaCytol1989;33:791-796.
8.Verma K, Tiwari MC, Agarwal J, Kapila K. Diagnostic accuracy of immediate interpretation of fine needle aspiration. Indian J Med Res 1991;94:197-199.
9.Chang MC, Chan RD, Ho WL. Intra operative cytology, the use of Liu’s stain for immediate diagnosis. Zhonghua Yi XueZaZhi (Taipei) 1993;51:368-375.
10.Yang GC, Alvaraz ll. Ultra fastpapanicolaou stain. An alternative preparation for fine needle aspiration cytology. ActaCytol1995;39:55-60.
11.Tsou MH, Lin HH, Ko JS. Riu’s Stain and the cytologic diagnosis of thyroid fine needle aspiration a single cancer center experience. DiagnCytopathol1997;16:543-547.
12.Caya JG, Clower LJ, Wollenberg NJ, Tiev TM. Transthoracoc fine needle aspiration cytology, Analysis of 82 patients with detailed verification criteria and evaluation of false negative cases. Am J ClinPathol1984;82:100-103.
13.Winning AJ, Seed MJ, Husain WA, Metaxas OAN. Interpretation of Negative results in fine needle aspiration of discrete pulmonary lesions. Thorax 1986;41:875-9.
14.Cagle PT, Kovach M. Ramzy I. Causes of false results in transthoracic fine needle aspirates. ActaCytol1993;37:16-20.
15.David J, Henry CK, Feider, Splittgerber GF. Toluidine blue dye as a breast localization marker. Am J Roentqenol1989;153:261-263.
16.Dudgeon LS, Patrick CV. A new method for the rapid microscopical diagnosis of tumors. Br J Surg1927;15:250-261.
17.Orell SR. Fine needle aspiration cytology. 5th ed. New Delhi: Elsevier; 2013.
Published
2017-12-22
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