Clear nuclei are specific to papillary carcinoma in thyroid fine-needle aspirates processed by Ultrafast Papanicolaou stain

Comparison of Ultrafast Papanicolaou Stain with the Standard Papanicolaou Stain in Body Fluids and Fine Needle Aspiration Specimens

INTRODUCTION

Most cytology laboratories in all Gulf countries including Oman, use the standard papanicolaou (PAP) method to stain various cytological specimens. The aim of this study was to investigate the possible application of ultrafast PAP (UF-PAP) method in cytology laboratory.

MATERIALS AND METHODS

Samples from 46 patients containing 26 body fluids and 20 fine needle aspirations (FNAs) (9 thyroids and 11 breasts) were collected. Two air dried and two wet smears from each sample were prepared and stained by UF-PAP and the standard PAP stains, respectively. Background, nuclear staining, cell morphology, and overall staining were independently reviewed by two cytoscreeners.

RESULTS

In all cases of FNA, UF-PAP stain gave a good score for the background, nuclear staining, cell morphology, and overall staining when compared with the standard PAP method. Although the correct diagnosis was made in all cases of body cavity fluids cases except in one case, UF-PAP stain gave a fewer score in the assessment of body cavity fluid samples.

CONCLUSION

The findings of this study support the use of UF-PAP method in cytology laboratory with a high emphasis on FNA samples.

Comparison of modified ultrafast Papanicolaou stain with the standard rapid Papanicolaou stain in cytology of various organs

BACKGROUND

Since the first introduction of Papanicolaou (Pap) stain in 1942 there have been many modifications. Of these, the Ultra-Fast Pap stain has become popular. This technique was further modified in India as many of the reagents were not available in our country. Our study was conducted by adapting this modified staining technique which involves the replacement of Gill's hematoxylin with Harris hematoxylin.

AIMS

The aim of our prospective study was to assess the use of the modified Ultra-Fast Pap stain (MUFP) for fine needle aspiration cytology (FNAC) of various organs in comparison with the standard rapid Pap stain.

MATERIALS AND METHODS

A total of 100 FNAC cases were studied by random sampling. Two smears were prepared for each case and stained by both, the MUFP and the rapid Pap stain. Scores were given and the quality index was calculated, followed by the statistical analysis. The number of cases was as follows: lymph node (43), thyroid (25), breast (23), salivary gland (02), and soft tissues (07). Scores were given on four parameters: Background of smears, overall staining pattern, cell morphology and nuclear staining. Quality index was calculated from the ratio of score achieved to the maximum score possible.

STATISTICAL ANALYSIS

Results were analyzed using Mean, Median, Standard Deviation, 't' paired test, 'P' value and M-diff for statistical significance.

RESULTS

Correct diagnosis was made in all cases. The quality index of MUFP smears was better compared to the rapid Pap stain in all the organs, and was statistically significant. MUFP smears showed a clear red blood cells background, transparent cytoplasm and crisp nuclear features.

CONCLUSION

MUFP is a reliable and rapid technique for cytology diagnosis.

Application of modified ultrafast Papanicolaou stain in cytology of various organs

This prospective study was conducted to assess the use of modified ultrafast Papanicolaou (MUFP) stain for fine-needle aspiration cytology (FNAC) of various organs. In India, many reagents are not easily available. In this modification, Gill's haematoxylin, EA-36, and isopropanol substitute Richard-Allan haematoxylin, cytostain, and ethanol, respectively. Group I included 40 FNAC smears of various organs. In each case, three smears were prepared and stained by MUFP, Papanicolaou, and May-Grunwald Giemsa (MGG) stains. In group II, 10 intraoperative cytology smears of different organs were stained with MUFP and rapid haematoxylin-eosin (H&E). For assessment of MUFP stain, scores were given on four parameters: background of smears, overall staining pattern, cell morphology, and nuclear staining. Quality index was calculated from ratio of score achieved to maximum possible score. Diagnosis made by MUFP stain was compared with standard stains. It was observed that MUFP-stained smears had clear RBC free background, crisp nuclear chromatin, well-stained nucleoli, and transparent cytoplasm. The diagnosis made was correct except in three cases of metastatic squamous-cell carcinoma. Hence, it was concluded that MUFP stain is useful for rapid diagnosis by FNAC, but is not useful for squamous-cell lesions.