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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