Endoscopy 2011; 43 - A136
DOI: 10.1055/s-0031-1292207

Application of Ultrafast Papanicolaou Stain in EUS-FNA Cytology

Cheng Tsu-Yao 1, Sun Meng-Shun 2, Yang Chang-Shyue 3, Chen Jiann-Hwa 4, Wang Hsiu-Po 1
  • 1Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • 2Department of Internal Medicine, Yuan's General Hospital, Kaohsiung, Taiwan
  • 3Department of Internal Medicine, En Chu Kong Hospital, Taipei, Taiwan
  • 4Buddhist Tzu-Chi Xin-Dian Hospital, Taipei, Taiwan

Purpose:

On-site cytology evaluation of EUS-FNA specimens is useful for quality assurance with improved diagnostic yield. Currently, the method for rapid assessment of FNA smears would be rapid Romanowsky-type stain such as Diff-Quik, Hemacolor stain or its equivalent. However, Romanowsky-type stain is inferior to Papanicolaou stain in subtle nuclear presentations. The objective of this study was to evaluate whether Ultrafast Papanicolaou (UFP) stain with 90-second protocol could be helpful in EUS-FNA on-site cytology.

Methods:

From May 2010 to July 2010, 21 consecutive patients received EUS-FNA procedures at NTUH. The mean age was 61.5 years old, with a range from 34 to 87 years. Ten of the patients were women. The indications for EUS-FNA included pancreatic mass, peripancreatic lymph node, and mediastinal mass without a tissue diagnosis. In this study, we adopted UFP stain with Hematoxylin 2 and Cyto-stain for on-site cytology assessment along with Hemacolor stain.

Results:

On-site cytology evaluation with UFP stain could offer comparable accuracy as Hemacolor stain. Furthermore, UFP stain retained transparency with polychromasia as traditional Papanicolaou stain, and presented with better nuclear details than Hemacolor stain. Tumors with distinctive nuclear pattern such as pancreatic endocrine tumor would be easily demonstrated by UFP stain and made prompt on-site diagnosis possible. In addition, rehydration procedure would hemolysis RBCs with a clear background facilitating interpretation of EUS-FNA specimens from hypervascular tumors or lymph nodes.

Conclusion:

UFP stain has offered complementary effects to rapid Romanowsky-type stain with better nuclear features. Specimen adequacy evaluation would also be easier for endosonographers with much clear background. Combination of UFP stain and rapid Romanowsky-type stain may aid in rapid EUS-FNA cytology diagnosis with good accuracy.