Also, cytologic preparations have a shorter turnaround time and are potentially cheaper than biopsies. Cytologic specimens should first be examined at low/scanning power to assess smear background, overall cellularity, cellular preservation and architectural arrangements. Next, high power systematic screening should be performed for the presence of infectious agents and cytologic abnormalities. Reporting should include a mention of the specimen adequacy and sample preservation, and diagnostic

Inhibitors,research,lifescience,medical language should be similar to that used for reporting histopathologic samples, with which clinicians are familiar. Every attempt should be made to give as definitive a diagnosis as possible. In cases where a specific Inhibitors,research,lifescience,medical diagnosis cannot be rendered, a differential or broader category should be used and the reason(s) for doing so should be reported. It is extremely helpful to discuss the more ambiguous cases with the responsible clinicians before the final report is rendered. Cytology is a screening as well as a Selleck SRT1720 diagnostic procedure. The absence of positivity for

a malignant process does not exclude malignancy, as the sensitivity of the procedure is less than 100%. As always clinical, serologic (in certain cases) and radiologic Inhibitors,research,lifescience,medical correlation is essential with repeat sampling for suboptimal/inadequate samples or for additional ancillary testing. Interdisciplinary discussions (as in tumor boards) should be performed before definitive treatment Inhibitors,research,lifescience,medical is instituted. Cytologic reporting Cytologic diagnoses are reported using the conventional diagnostic nomenclature for nongynecologiccytologic

specimens. The five general diagnostic categories are unsatisfactory, negative for malignancy, atypical/indeterminate, suspicious for malignancy, and positive for malignancy. If clinical and radiologic findings Inhibitors,research,lifescience,medical correlate as either benign or malignant with cytologic findings, the diagnoses are considered conclusive for benign or malignant disease. No additional or confirmatory studies are usually indicated. For lesions in which the clinical, radiologic, and cytologic diagnoses differ, additional studies almost are indicated. Also atypical/indeterminate and suspicious for malignancy cytologic diagnoses may warrant further diagnostic studies (12). Specimen collection methods Lavage Lavage of mucosal lesions with isotonic saline. Salvage cytology First endoscopic biopsies of suspicious lesions are performed. Next the brush, biopsy forceps or the cytology brush channel of the endoscope is rinsed with a balanced salt solution. The sample is then centrifuged or filtered to produce smears and cell blocks. Brushings Brushings are obtained via the biopsy channel of the endoscope with two or three smears made with a rapid rolling motion of the brush on glass slides.