Contribution of cell blocks obtained through endobronchial ultrasound-guided transbronchial needle aspiration for the determination of lung cancer subtypes

Clin Respir J. 2018 Apr;12(4):1623-1627. doi: 10.1111/crj.12719. Epub 2017 Oct 26.

Abstract

Introduction: It is crucial to diagnose the subtype of lung cancer quickly and accurately for effective therapy. Conventional cytology staining sometimes provides limited information, and additional tissue is often required to diagnose lung cancer. Cell blocks (CB) recovered during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) increases the diagnostic accuracy of the procedure and the likelihood of additional valuable histochemical and immunohistochemical staining.

Objectives: To evaluate the diagnostic significance of smears and CBs for lung cancer subtypes METHODS: Records of patients who underwent EBUS-TBNA between July 2014 and December 2016 for lung cancer diagnosis and/or staging were retrospectively analysed.

Results: The study included 156 patients and 232 LNs diagnosed as malignancies. Twenty-seven patients were diagnosed with small cell lung cancer (SCLC), and 129 were diagnosed with non-small cell lung carcinoma (NSCLC) (68 patients adenocarcinoma, 36 patients squamous cell carcinoma, 23 patients NSCLC if not otherwise stated, 1 patient large cell carcinoma and 1 patient pleomorphic carcinoma). The mean age was 60.5 ± 10.2 years, and 74.5% of the patients were males. The diagnostic rate for CBs was 231/232 (99.6%) and was 206/232 (88.8%) (P < .001) for smears. The diagnostic rate for SCLC was 37/39 (94.9%) for smears and 39/39 (100%) for CB (P < .001). For NSCLC, it was 169/193 (87.6%) for smears and 192/193 (99.5%) for CB (P < .001).

Conclusions: Cell-block preparation after an EBUS-TBNA is a simple method that provides important additional information related to lung cancer for morphological analyses.

Keywords: cell block; cytological smear; endobronchial ultrasound; lung cancer; transbronchial needle aspiration.

MeSH terms

  • Bronchoscopy
  • Diagnosis, Differential
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / methods*
  • Female
  • Humans
  • Lung / pathology*
  • Lung Neoplasms / pathology*
  • Male
  • Middle Aged
  • Neoplasm Staging / methods*
  • Reproducibility of Results
  • Retrospective Studies