Utility of Lemon Solution Rehydration Technique for Processing Haemorrhagic Cytology Samples: A Comparative Study using Different Techniques
EC06-EC13
Correspondence
BN Kumarguru,
‘Sri’ Nivasa No: 204, 9th Cross, BEML Layout, 1st Stage, Basaveshwaranagar-560079,
Bangalore, Karnataka, India.
E-mail: kumarguru1978@yahoo.com
Introduction: Haemorrhagic fluids samples are commonly received for cytological evaluation. The presence of erythrocytes obscures the morphology of cells and thus poses great diagnostic difficulty. Haemorrhagic body fluids are processed by using a variety of techniques. The idea of each technique is to select and concentrate an adequate number of tumor cells having intact cell morphologies, without losing the diagnostically important cells during processing.
Aim: To evaluate the effect of known haemolysing solutions [Carnoy’s Fixative (CF) and normal saline {Normal Saline Rehydration Technique (NSRT)}] and 10% lemon solution {Lemon Solution Rehydration Technique (LSRT)} on haemorrhagic cytology samples; and to compare various cytomorphological features in haemorrhagic cytology samples processed by different haemolysing solutions.
Materials and Methods: It was an analytical study done at a rural tertiary care referral institute, PES Institute of Medical Sciences and Research (PESIMSR), Kuppam, Andhra Pradesh, India. Fifty-seven haemorrhagic samples were analysed. For each case, totally eight smears were prepared. Out of eight smears, two smears served as control (not treated with any haemolysing agent. Remaining six smears (two smears each) were treated with haemolysing agents (CF, normal saline and 10% lemon solution).
Smears stained with Haematoxylin and Eosin (H&E) and May-Grunwald Geimsa (MGG) stains were evaluated for haemolysis in the smear background, retention of cells and cytomorphological details in comparison with control smears. Each smear were scored (1-4) according to a modified scoring system. Chi-square test was the statistical tool used to analyse the data in the study.
Results: MGG stained smears showed best haemolysing effect with NSRT (78.95%), maximum retention with LSRT (85.96%) and best cytomorphological details with CF (12.28%). H&E stained smears showed best haemolytic effect with LSRT (56.14%), maximum retention with LSRT (87.72%) and best cytomorphological details with CF (8.77%).
Conclusion: LSRT is a novel rehydration technique developed to improve the quality of processing haemorrhagic cytology samples. LSRT showed best overall performance and it may be utilised to overcome the disadvantages of CF and NSRT.