Journal Club: Utility of anticoagulation, pre-smearing and post-smearing hemolytic techniques on morphological assessment, reproducibility in fluid cytology

A recent research article was conducted to determine the effect of anticoagulation, pre-smearing acetic acid treatment technique, and saline rehydration technique on morphological assessment, reproducibility, and reporting in fluid cytology.

The study is published in the Cyto Journal published by Scientific Scholar.

Knowledge of proper collection, storage, preservation, and processing techniques is critical to ensuring proper handling and analysis of fluid cytology specimens.With this objective, the present study was conducted and was carried out in the cytopathology laboratory over 2 months where 100 effusion samples were analyzed.

At least 20–40 mL of fluid was collected in heparinized and non-heparinized containers for each patient. Samples were processed in cytospin and stained with Giemsa and Papanicolaou stains. For 70 hemorrhagic specimens, an extra smear was prepared from the sediment and subjected to the saline rehydration technique.

Seventy-three hemorrhagic specimens whose quantity received was more than 35 mL were subjected to the pre-smearing technique. These smears were evaluated for (a) the presence or absence of blue background/any other background staining, (b) cellularity, (c) cell morphology and (d) the presence/absence of microclots.

The results showed that heparinized samples showed no compromise in cellular morphology or cellularity although a blue background was observed in an occasional case. The pre-smearing technique had less background hemorrhage and preserved cell characteristics. The post-smearing saline rehydration technique did not compromise the cellularity but distorted morphology and showed background staining.

Therefore, the authors concluded that the pre-smearing acetic acid treatment showed better-preserved cellularity and cytomorphology with the absence of background staining when compared to the post-smearing saline rehydration technique.

Reference: Agrawal M, Lata P, Singh M, Lal MK, Gupta B, Shamsunder S, et al. Utility of anticoagulation, pre-smearing and post-smearing hemolytic techniques on morphological assessment and reproducibility in fluid cytology. CytoJournal 2024;21:9. doi: 10.25259/Cytojournal_51_2023