From the Guidelines
Non-gynecological cytology refers to the study of cells from bodily tissues and fluids outside of the female reproductive system, including the examination of cells from various sites such as the lungs, liver, pancreas, and other organs to aid in the diagnosis of diseases, including cancer 1.
Key Examples
- Sputum cytology is a type of non-gynecological cytology that involves the examination of cells from sputum samples to diagnose lung cancer, with a sensitivity ranging from 42% to 97% and a specificity ranging from 68% to 100% 1.
- Other examples of non-gynecological cytology include fine-needle aspiration cytology and urine cytology.
Important Considerations
- The diagnostic accuracy of non-gynecological cytology depends on rigorous specimen sampling and preservation techniques, as well as on the location and size of the tumor 1.
- Patient characteristics associated with positive cytologic diagnosis on sputum include bloody sputum, low FEV1 values, large lung tumors, centrally located tumors, and squamous cell cancers 1.
Clinical Applications
- Non-gynecological cytology is particularly useful in patients who present with centrally located tumors and in those who present with hemoptysis 1.
- Sampling of sputum specimens should be the first step in a patient who presents with a central lesion and radiographic evidence of metastatic disease, in whom a semi-invasive procedure such as bronchoscopy or TTNA might pose a higher risk 1.
From the Research
Definition of Non-Gynecological Cytology
Non-gynecological cytology refers to the study of cells from non-gynecologic sites, such as fine needle aspirations (FNA) from various organs and body cavities 2.
Characteristics of Non-Gynecological Cytology
The characteristics of non-gynecological cytology include:
- Cleaner background with altered or reduced background and extracellular elements 2
- Architectural changes such as smaller cell clusters and sheets, breakage of papillae 2
- Altered cell distribution with more dyscohesion and changes in cellular morphology with enhanced nuclear features, smaller cell size and slightly more three-dimensional (3-D) clusters 2
- Presence of evenly dispersed cells, clearance of obscuring elements/background debris, and better cellular details 3
Comparison with Conventional Cytology
Non-gynecological cytology using liquid-based cytology (LBC) has been compared to conventional cytology smears, with LBC showing:
- Better diagnostic accuracy due to lack of background debris and better cell morphology 4
- Improved visualization of cells due to even distribution of cells, decreasing obscuring background elements, and well-preserved nuclear and cytoplasmic details 4
- However, in some cases, conventional cytology smears may be necessary to support the diagnosis, especially when background factors are essential diagnostic clues 4
Applications of Non-Gynecological Cytology
Non-gynecological cytology has been applied to various sites, including: