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DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7418.24

Abstract

Background: Fine needle aspiration cytology (FNAC) is a very important component of pre-operative investigation in combination with clinical, radiological and other laboratory data. In spite of its advances and advantages, conventional FNAC fails to achieve a 100% accuracy. To improve the accuracy of FNAC, a supravital stained Toluidine blue wet mount (TBWM) preparation of the aspirate and Methylene blue/Eosin (M/E) stained smears are studied

Aim: To assess the diagnostic rapidity of the Toluidine blue wet mount preparation and Methylene blue/Eosin stain in FNAC and to compare the morphological features and results obtained from rapid stains with conventional PAP and H&E techniques in FNAC.

Materials and Methods: The study was conducted on Fine needle aspirates from 96 patients presenting with breast lump in the Department of Pathology. TBWM, M/E stain, H&E stain and Pap stain was done for all 96 cases. Time taken for each stain is assessed and the morphology of rapid stains were compared with the conventional stain. Quality index was calculated for all the stains.

Statistical Analysis: Validation was done using tests like Sensitivity, Specificity, Positive predictive value and ROC curve. The p value £ 0.05 was considered significant.

Results: Toluidine blue wet mount takes only 2 minutes for staining followed by Methylene blue/eosin which takes 5 minutes. M/E stain gave the same result as compared to the conventional stains [PAP and H&E]. In TBWM there was difficulty in diagnosing few cases due to three dimensional clusters. The sensitivity and specificity of TBWM were 68% and 94% whereas for M/E stain 99% and 100%. The quality index of PAP stain, H&E stain, M/E stain and TBWM were 0.86, 0.82, 0.72, 0.66 respectively.

Conclusion: TBWM and M/E stain can be routinely undertaken as a supplementary procedure for conventional stains to improve the cellularity and to reduce the time taken for re-sampling.

Keywords: Toludine Blue Wet Mount; Methylene/Eosin; Rapid Cytodiagnosis; Quality Index. 

Corresponding Author : Veena Raja, Assistant Professor, Department of Pathology, SRM Medical College and Research Institite, SRM University, Kattankulathur, Chennai, Tamil Nadu 603203, India.