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Diagn Cytopathol. 2018 Sep;46(9):725-729. doi: 10.1002/dc.24036. Epub 2018 Jul 27.

The new guidelines of Papanicolaou Society of Cytopathology for respiratory specimens: Assessment of risk of malignancy and diagnostic yield in different cytological modalities.

Author information

1
Cancer signaling metabolism-Epithelial Interactions in Cancer, I3S, Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.
2
Department of Pathology subdivision of Cytopathology, Acibadem Mehmet Ali Aydınlar University, Kayısdagı cd. Atasehir-Istanbul-TR, Turkey.
3
Department of Pathology, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal.
4
Medical Faculty of 4th year, Acibadem Mehmet Ali Aydınlar University, Kayısdagı cd, Atasehir-Istanbul-TR, Turkey.
5
Department of Pathology, Acibadem Laboratory, Kayısdagı cd, Atasehir- Istanbul-TR, Turkey.
6
Acibadem University, Department of Interventional Radiology, Acibadem Mehmet Ali Aydınlar University, Kayısdagı cd, Atasehir- Istanbul-TR, Turkey.
7
Unit of Molecular Pathology, IPATIMUP, Institute of Molecular Pathology and Immunology of University of Porto, Porto, Portugal.
8
Department of Pathology, Medical Faculty of Porto University, Porto, Portugal.

Abstract

BACKGROUND:

In 2016, the Papanicolaou Society of Cytopathology (PSC) issued a new classification scheme for respiratory cytology. We aim to evaluate our samples according to this classification and to assess risk of malignancy and diagnostic yield of different cytological modalities.

METHODS:

Respiratory specimens (sputum, bronchial wash/brush, BAL and FNA) obtained between 2007 and 2016 were reclassified according to PSC guidelines. Risk of malignancy for each diagnostic category was determined. Diagnostic yield was evaluated based on three-categorical approach.

RESULTS:

One thousand, two hundred and ninety respiratory specimens were retrieved, of which 280 had histologic follow-up. Samples were reclassified as nondiagnostic 16%, negative for malignancy 53%, atypical 5.4%, neoplastic (benign neoplasm/low-grade carcinoma) 0.4%, suspicious for malignancy 2.1% and malignant 23.1%. Risk of malignancy for each category was 64.01% for ND, 48.27% for NM, 59.09% for A, 100% for N-B-LG; 90% for SM and 89.74% for M. When only malignant cases were considered positive tests, cytology sensitivity was 55% and specificity 88%.

CONCLUSION:

Our results were in line with PSC guidelines, but the use of multiple cytological techniques may cause some discrepancies in overall diagnostic yield and in estimated risks of malignancy, which is important due to the widespread utilization of different cytological procedures.

KEYWORDS:

PSC guidelines; lung; respiratory cytology

PMID:
30051969
DOI:
10.1002/dc.24036
[Indexed for MEDLINE]

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