Specimen Collection and Processing

  • Yener S. Erozan
  • Ibrahim Ramzy
Part of the Essentials in Cytopathology book series (EICP, volume 6)

Proper collection and processing of cytologic specimens are crucial for an accurate cytopathologic diagnosis. In most instances, failure to establish a definitive diagnosis is caused either by inadequate sampling of the lesion or by suboptimal preparation of the specimen.

Specimen Collection

Pulmonary specimen collection techniques are listed in Table 1.1. The most frequently used techniques in current practice are bronchoscopy and fine needle aspiration (FNA). FNAs (transbronchial or transthoracic) are performed under imaging guidance, i.e., ultrasound (US) or computed tomography (CT). More recently, EUS guided FNA is increasingly used in the diagnosis of mediastinal lesions and the staging of lung cancer. On-site evaluation for adequacy improves the yield of diagnosis in FNA. Selection of the technique is determined by the location of the lesion (Table 1.2) and also the expertise of the physician (e.g., radiologist, pulmonologist) performing the procedure.
Table 1.1



Fine Needle Aspiration Core Biopsy Hank Balance Salt Solution Cell Block Polypropylene Glycol 
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Suggested Reading

  1. Baker JJ, Solanki PH, Schenk DA, et al. Transbronchial fine needle aspiration of the mediastinum: importance of lymphocytes as an indicator of specimen adequacy. Acta Cytol 1990;3:517–523Google Scholar
  2. Cham MD, Lane ME, Henschke CI, Yankelevitz DF. Lung biopsy: special techniques. Semin Respir Crit Care Med 2008 Aug;29(4):335–349PubMedCrossRefGoogle Scholar
  3. Chamberlain DW, Braude AC, Rebuck AS. A critical evaluation of bronchoalveolar lavage: criteria for identifying unsatisfactory specimens. Acta Cytol 1987;31:599–605PubMedGoogle Scholar
  4. Choi Y-D, Han C-W, Kim J-H, et al. Effectiveness of sputum cytology using ThinPrep® method for evaluation of lung cancer. Diagn Cytopathol 2008;36:167–171PubMedCrossRefGoogle Scholar
  5. Dabbs DJ. Diagnostic immunohistochemistry, edn 2, Philadelphia, PA, Churchill Livingstone, 2006Google Scholar
  6. Fischler DF, Toddy SM. Non-gynecologic cytology utilizing the ThinPrep processor. Acta Cytol 1996;40:669–675PubMedCrossRefGoogle Scholar
  7. Fraire AE, Underwood RD, McLarty JW, et al. Conventional respiratory cytology versus fine needle aspiration cytology in the diagnosis of lung cancer. Acta Cytol 1991;35:385–388PubMedGoogle Scholar
  8. Garg S, Handa U, Mohan H, et al. Comparative analysis of various cytohistological techniques in diagnosis of lung diseases. Diagn Cytopathol 2007;35:26–31PubMedCrossRefGoogle Scholar
  9. Hawes RH, Gress F, Kesler KA, et al. Endoscopic ultrasound versus computed tomography in the evaluation of the mediastinum in patients with non-small cell lung cancer. Endoscopy 1994;26:784–787PubMedCrossRefGoogle Scholar
  10. Layfield L, Coogan A, Johnson WW, et al. Transthoracic fine needle aspiration biopsy: sensitivity in relation to guidance technique and lesion size and location. Acta Cytol 1996;40:687–690PubMedCrossRefGoogle Scholar
  11. Linder J, Rennard SI. Bronchoalveolar lavage. Chicago, ASCP Press, 1988Google Scholar
  12. Rivera MP, Mehta AC. Initial diagnosis of lung cancer. ACCP Evidence-based Clinical Practice Guideline (2nd edn). Chest 2007;132: 131S–148SPubMedCrossRefGoogle Scholar
  13. Rowe LR, Mulvihill SJ, Emerson L et al. Subcutaneous tumor seeding following needle core biopsy of hepatocellular carcinoma. Diagn Cytopathol 2007;35:717–721PubMedCrossRefGoogle Scholar
  14. Savoy AD, Ravenel JG, Hoffman BJ, et al. Endoscopic ultrasound for thoracic malignancy: a review. Curr Probl Diagn Radiol 2005;34: 106–115PubMedCrossRefGoogle Scholar
  15. Sawhney MS, Kratzke RA, Lederle FA, et al. EUS-guided FNA for the diagnosis of advanced lung cancer. Gastrointest Endosc 2006;63: 959–965PubMedCrossRefGoogle Scholar
  16. Tournoy KG, Praet MM, Van Maele G, et al. Esophageal endoscopic ultrasound with fine-needle aspiration with an on-site cytopathologist: high accuracy for the diagnosis of mediastinal lymphadenopathy. Chest 2005;128:3004–3009PubMedCrossRefGoogle Scholar
  17. Vilmann P, Krasnik M, Larsen SS, et al. Transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-YBNA) biopsy: a combined approach in the evaluation of mediastinal lesions. Endoscopy 2005;37:833–839PubMedCrossRefGoogle Scholar
  18. Vincent BD, El-Bayoumi E, Hofman B, et al. Real-time endobronchial ultrasound-guided transbronchial lymph node aspiration. Ann Thorac Surg 2008;85:224–230PubMedCrossRefGoogle Scholar
  19. Yung RC. Tissue diagnosis of suspected lung cancer: selecting between bronchoscopy, transthoracic needle aspiration, and resectional biopsy. Respir Care Clin N Am 2003;9:51–76PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Johns Hopkins School of MedicineBaltimoreUSA
  2. 2.University of IrvineUSA

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