Specimen Types in Respiratory Cytology and Adequacy Criteria

Michael J. Thrall, MD

Pulmonary macrophages are critical for confirming alveolar sampling. This Pap stain shows key features, including foamy cytoplasm with fine anthracotic pigment

and bean-shaped nuclei

Normal respiratory-type bronchial mucosa, shown here in a Pap stain, has basally oriented nuclei

and abundant foamy apical cytoplasm with terminal bars and cilia

TERMINOLOGY

Definitions

Sputum
- Coughed-up lung fluids expectorated by patient either from spontaneous bronchial mucus or from mucus induced by inhaled vapors
Bronchoalveolar lavage (BAL)
- Lavage fluid collected from alveolated lung parenchyma via bronchoscope wedged into a subsegmental bronchus
Bronchial brushing
- Bronchial mucosa directly brushed during bronchoscopy
Bronchial washing
- Lavage fluid collected from an area of bronchial wall
Fine-needle aspiration (FNA)
- Sampling from a mass lesion using aspiration through a small-bore needle
- Transbronchial FNA (TB-FNA) is performed through a bronchoscope
  - FNA performed without radiologic guidance is often known as a Wang needle procedure
  - FNA may also be performed using endobronchial ultrasound (EBUS) system attached to bronchoscope
    
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