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At the TVCS
meeting in St Mary's Hospital on the 11th November 2004 Dr. Herbert
gave us an interesting talk on cytology of the pleura.
She started
with information about why it can be a good diagnostic tool as it
is a quick and non-invasive procedure for the patient, but she emphasised
the need for good preparations. The technical quality of the slides
is most important.
In her opinion
cytospin preparations are best for air-dried slides that can be
used for immunocytochemistry as well as MGG, but spreads or LBC
slides are best for fixed slides (Figure.1). If LBC is used routinely
then it maybe useful to halve the sample before proceeding so that
both fixed and air-dried slides can be produced. Cellblock techniques
also have their uses as they allow for multiple sections to be cut
and a wider range of special stains to be performed (Figure.2).
The gross appearance
of the sample e.g. colour and opacity, is very useful as this can
give clues as to the likely cellularity of the specimen.
Dr. Herbert
then gave a more in depth talk about the cytopathology of effusions
linking cell types with findings and likely useful antibody panels
in immunocytochemistry that would aid diagnosis. She emphasised
the need for careful examination of the slides.
Dr. Herbert
summarised her talk with the following points -
" False positive diagnosis should be rare.
" Understanding
the mechanism of effusions helps diagnosis.
" Accuracy of the diagnosis is often improved by immuncytochemistry.
" Technical expertise is central to the accuracy of cytodiagnosis.
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