EBUS/EUS - Cell smears or cytoblocks?

Aim: The aim of the study was to compare a diagnostic efficacy of cytopathologic material in cell smears and cytoblocks obtained from EBUS-TBNA and EUS-FNA. Material and methods: Between 2010-2012 a cytological material was analysed from 742 patients in whom EBUS-TBNA and/or EUS-FNA was performed. In 304 patients, standard cytologic smears were performed on glass slides and fixed in 96% ethanol. In 438 patients, aspirate was fixed directly in CYTOSPIN™ and a regular histologic technique using paraffin-embedded cytoblocks were prepared. In 78 cases, both methods, cell smears and cytoblocks were performed. Both methods were also compared in context of further immunohistochemical and molecular assays. Results: Cell smears were diagnostic in 206 (67.8%) patients: 88 positive for cancer, 93 negative for cancer, 4 suspected for having lung cancer metastases and 21 positive for sarcoid granulomas. Cytoblocks were diagnostic in 299 (68.3%) patients: 149 positive for cancer, 103 negative for cancer, 4 suspected for having lung cancer metastases and 43 positive for sarcoid granulomas. A diagnostic yield of each method was comparable (p>0.05). The third approach combining both methods was diagnostic in 67 (85.9%) patients: 31 positive for cancer, 22 negative for cancer, 2 suspected for having lung cancer metastases and 12 positive for sarcoidosis. A diagnostic yield of the cytological combining approach was significantly higher comparing to each method alone (p Conclusion: After our data the diagnostic yield of standard cell smears and cytoblocks are comparable. Nevertheless, the combined approach of both cytological methods seems to be the best option for diagnostic purposes while using EBUS-TBNA and EUS-FNA.