Merits and pitfalls of normal saline rehydrated air-dried cervical smears over conventional wet.fixed PAP smears: A comparative study

Background: Cervical Papanicolaou (PAP) smear is the simplest, minimal invasive, and excellent screening method to reduce the female morbidity and mortality due to cervical carcinoma. Immediate alcohol fixation of the cervical smears is required to preserve nuclear details, delay in alcohol fixation leads to air drying artifacts. Rehydrating of the air-dried cervical pap smear with normal saline can help to overcome these artifacts and also have its own advantages. Aims: This study was design to evaluate the effects, merits and pitfalls of normal saline Rehydrated Air-Dried Cervical PAP Smears (RADPS) compared with the Conventional Papanicolaou Smear (C-PAPS). Settings and Design: Comparative study. Methods and Material: Prospectively paired cervical smears of 100 women, who presented to the outpatient department of gynecology of our institute, were prepared. Alcohol fixed smears were labelled as conventional Papanicolaou smear (C-PAPS) and air-dried smears labelled as rehydrated air-dried PAP smears (RADPS). Eight cytomorphological parameters were considered for comparison and analyzed. Statistical analysis used: Chisquare (?2)/Fisher exact test. Results: Clear background with red blood cells (RBC) lysis was noted in 93% of RADPS and 54% of C-PAPS. Cytolysis was observed more in C-PAPS (18%) than in RADPS (08%). Air-drying artifacts observed in 30% of C-PAPS and 08% of RADPS. Cytoplasmic staining (92% of RADPS and 85% of C-PAPS) was superior in RADPS. Cell border, nuclear chromatin, and border were also better appreciated on RADPS as compared to C-PAPS. Statistically significant difference was observed with 3 parameters, i.e., air-drying artifacts, RBC background, and distinct cell borders. Conclusion: Rehydration of air-dried smears can be adopted in regular practice, as an alternative or coupled with conventional wet fixation method to overcome the commonly faced problems of air-drying artifacts, especially in rural screening programs.

Sclerosing lobular hyperplasia – cytological similarity to fi broadenoma

Mammary sclerosing lobular hyperplasia (SLH) is a rare, benign, fi broproliferative tumour-like lesion of adolescent and young women often of African-American heritage. Fine-needle aspiration cytology of mammary SLH shows characteristic features that include an absence of stromal fragments. We report a 45-year-old woman who presented with a gradually enlarging, painless, mobile 4-cm tumour in her left breast. Fine-needle aspiration cytology performed preoperatively was characterized by some fi broadenoma-like features including the presence of stromal fragments and bare nuclei. However branched tubular fragments, typical of fi broadenoma, were not seen. A diagnosis of benign epithelial lesion of the breast was offered, and the possibility of a fi broadenoma was suggested. Excision biopsy histology revealed SLH. The key cytological features of mammary SLH are bland ductal epithelial cell clusters, few scattered fragments of stroma, relatively clean background with a fair number of bare nuclei. However these are not diagnostic as they overlap with those of fi broadenoma and distinction between the two benign entities is of no clinical signifi cance. The defi nitive diagnosis of SLH requires histopathological evaluation.