A Case of Metastatic Angiosarcoma Diagnosed by Liquid-Based Preparation: Peculiar Cytoplasmic Changes

Angiosarcoma with predominantly epithelioid features is a rare soft tissue neoplasm and the interpretation of its cytopathologic findings may be difficult. We report a case of metastatic angiosarcoma with predominantly epithelioid features diagnosed by liquid-based cytology. The cytopathologic findings in this case differed from those of the conventional preparation and we found a clean background, no hyperchromatic nuclei and several cytoplasmic changes, including intracytoplasmic vacuoles with peculiar shapes, juxtanuclear condensation and perinuclear clearing. Identification of these changes using liquid-based cytology supplemented with immunochemistry may be helpful in reaching a correct cytopathologic diagnosis.

Comparison of Diagnostic Cytomorphology of Atypical Squamous Cells in Liquid-Based Preparations and Conventional Smears

BACKGROUND: The aims of this study were to compare the cytomorphologic features diagnostic of atypical squamous cells (ASC) in liquid-based preparations (LBPs) and conventional Pap (CP) smears and to cytomorphologically assess the performance of the Cell Scan 1500(TM) in cervical cytology practice. METHODS: Cervicovaginal smears were obtained from 938 women. Two smears were obtained simultaneously from each individual, one for an LBP and the other for a CP smear; the smears were independently examined. ASC was diagnosed in 24 patients, and their samples were cytomorphologically and semiquantitatively analyzed. RESULTS: A total of 24 of the 938 women (2.6%) were diagnosed with ASC by one or both methods. Results from LBPs and CP smears were in agreement in 13 of 24 cases of ASC diagnosis (absolute direct agreement, 54.2%; k<0.20; p-value from chi-square test=0.085). Diagnostic features of ASC in the LBPs included squamous cell atypia and atypical squamous metaplasia. CONCLUSIONS: The cellular features diagnostic of ASC present in one preparation can manifest themselves differently in the other. Changes in individual cells, particularly nuclear changes, are the most reliable features for diagnosing ASC. The Cell Scan 1500(TM) processor is more effective at detecting ASC than are CP smears.

Clinical Efficacy of Manual Liquid-Based Cervicovaginal CytologyPreparation: Comparative Study with Conventional Papanicolaou Test / 대한세포병리학회지

This study was performed to compare manual liquid-based preparation with conventional Papanicolaou tests in view of the cytologic diagnoses and specimen adequacy. The specimens of 5,979 women from 33 local clinics and 1 general hospital were prepared by both manual liquid-based preparation and conventional Papanicolaou test. The cytologic diagnoses and specimen adequacy were evaluated in Department of Pathology in Kyoungpook National University School of Medicine. A conventional Papanicolaou test was always prepared first, after that residual material on the sampling device was rinsed into a liquid preservative, and then thin-layer slides were prepared using manual method of liquid-based cervicovaginal cytology. Conventional and liquid-based slides were read independently, and cytologic diagnoses and specimen adequacy were classified using the Bethesda System. Of the cases, 5,763(96.3%) had the same interpretation, and there was no significant diagnostic difference in 5,853(97.8%) cases. When evaluating cases with more than one diagnostic class difference, the manual liquid-based preparation demonstrated a statistically significant overall improvement(2.1%) in the detection of squamous intraepithelial lesion and invasive cancer. Using manual method of liquid- based preparation, there was 14.1% reduction in unsatisfactory slides through excellent cellular presentations. In conclusion, the manual liquid-based preparation produces standardized quality, superior sensitivity and improved adequacy as compared to the conventional method.

Comparison of Efficacy between MonoPrep(R) and Papanicolaou Smear for Cervical Cancer Screening / 대한산부인과학회잡지

OBJECTIVE: To compare the specimen adequacy and cytologic diagnostic results of MonoPrep(R), a type of liquid based preparation, with the conventional Pap smear. METHODS: In randomly selected 156 patients who visited the department of Obstetrics and Gynecology, Ajou University Hospital for cervical biopsy, conventional Pap smear and matched MonoPrep(R) were performed. Statistical analysis was performed with chi-square test. RESULTS: There were more "Unsatisfactory" and "Satisfactory but limited by (SBLB)" results in the conventional Pap smear group, even though no statistical significance could be found between the two groups. ASC/LSIL ratio was significantly decreased in the MonoPrep(R) group, showing 0.4 with MonoPrep(R) and 1.9 with conventional Pap smear demonstrating a 78.4% decrease (P<0.001). In detecting abnormal cervical lesions, conventional pap smear showed a sensitivity of 87.7%, positive predictability of 82.3%, false negativity of 10.3%, while MonoPrep(R) showed a sensitivity of 94.8% (P=0.04), positive predictability of 97.4% (P<0.001), and false negativity of 2.6% (P=0.016). CONCLUSION: MonoPrep(R) is more effective for the detection of cervical lesions with higher sensitivity and lower false negativity compared to conventional pap smear.

A Comparision of AutoCyte PREP with Matched Conventional Smear in Cervicovaginal Cytology / 대한세포병리학회지

This study was designed to compare the performance of liquid-based preparation from the AutoCyte PREP with the conventional cervicovaginal smear in masked split-samples. In randomly selected 840 cases, the conventional smear was always prepared first, and the AutoCyte PREP used the residual cells on the collecting device. Parallel AutoCyte PREP slides and matched conventional smears were screened in a blind fashion. All abnormals and 10% random normal cases were reviewed by two pathologists in a blind fashion. The Bethesda System was used for reporting the diagnosis and specimen adequacy. The diagnoses from the two methods were agreed exactly in 767(91.3%) of 840 cases. The AutoCyte PREP demonstrated a 25% overall improvement in the detection of squamous intraepithelial lesion(SIL). The ratio of ASCUS to SIL was decreased as 0.45 compared with 1.00 of conventional smear. The AutoCyte PREP produced excellent cellular preservation and superior sensitivity for detection of atypical cells as compared to the conventional smear. It makes us to be able to subclassify ASCUS into from WNL to HSIL. We thought that the AutoCyte PREP method might contribute to increase the detection rate of abnormal cells than conventional methods.