The diagnostic value of cell blocks in Liquid-Based Cytology of bronchial aspiration and bronchial brushing materials.

INTRODUCTION: Fibreoptic bronchoscopy is used for the diagnosis and treatment of several pulmonary diseases. Conventional smear and Liquid-based cytology (LBC) methods are applied to cytology samples of various bronchoscopic techniques. If the cytology sample is sufficient for evaluation, a cell block (CB) can be prepared from the remaining material. The aim of this study is to identify the diagnostic value of conventional smear, LBC and CB methods in bronchial cytological specimens.

METHODS: A retrospective review of 329 samples from 240 patients was made and, of these, 144 patients were found to have neoplasia. A blind review of the specimens was performed and all were reclassified individually. The endoscopic findings of the 144 patients with neoplasia were analysed retrospectively. The cytological diagnoses were then compared with the final diagnosis or the endoscopic findings of patients with neoplasia. The sensitivity was calculated for each method, both separately and together.

RESULTS: It was determined that CB led to a 10.1% increase in the diagnostic sensitivity for bronchial aspiration (BA) specimens, while no significant increase was seen in bronchial brush specimens. In BA specimens of neoplasia patients with normal bronchoscopic findings, while three methods were applied together with an increase in the number of cases diagnosed as malignant cytology, there was no significant increase in bronchial brush specimens.

CONCLUSION: This study demonstrated that adding cell block to CB and LBC seemed to contribute the cytological diagnosis in BA materials significantly. Another advantage of CB is the opportunity of applying advanced methods such as immunocytochemical and molecular techniques.