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VOLUME 10 , ISSUE 1--4 ( January-December, 2024 ) > List of Articles

RESEARCH ARTICLE

Comparative Study of May-Grunwald Giemsa-stained Hemorrhagic Thyroid Aspirates with Turk's Fluid-treated Hemorrhagic Thyroid Aspirates to Improve the Quality of Fine Needle Aspiration Smears

Mythreyi MU, Sheetal, Jyothi A Raj, Shoubhik Patra, Bimala Pokhrel, Sharon Johnson

Keywords : Background retention of red blood cells, Cytoplasmic details, Hemolysis, Hemorrhagic thyroid aspirates, Nuclear details

DOI: 10.5005/jp-journals-10045-00278

License: CC BY-NC 4.0

Published Online: 30-07-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background: Fine needle aspiration cytology (FNAC) is a well-established, cost-effective, simple, outpatient department (OPD) procedure for the investigation of thyroid swellings. As the thyroid is a highly vascular organ, a large amount of blood gets aspirated, which obscures cell morphology. To improve the quality of hemorrhagic thyroid FNAC smears, a new technique is used and compared with the conventional method. Aim: To evaluate the effect of Turk's fluid, which lyses the red blood cells (RBCs) in hemorrhagic thyroid aspirates, and compare it with conventional May-Grunwald Giemsa (MGG)-stained hemorrhagic thyroid aspirate smears. Materials and methods: The present study was a prospective observational study conducted in the Department of Pathology, RajaRajeshwari Medical College, Bengaluru, for a period of 1 year (August 2022–August 2023). Forty-four cases were included in the study. After the thyroid FNA procedure, five smears were made from the aspirated material, out of which one smear was immediately treated with Turk's fluid for 45–60 seconds and stained by MGG stain to produce Turk's fluid treated Giemsa smear (TTG). Two smears were stained by conventional MGG, and the remaining two smears were stained by hematoxylin and eosin (H&E). The MGG smears were compared with the TTG smears and evaluated. Results: The background retention of RBCs significantly reduced in TTG smears when compared to MGG smears, which was statistically significant (p-value <0.01). The cytoplasmic details and the nuclear details of the thyroid follicular cells were better seen in TTG smears when compared to MGG smears and were statistically significant (p-value <0.001). In this study, the duration of Turk's fluid treatment was validated up to 45–60 seconds for better hemolysis, following which the nuclear and cytoplasmic details were better appreciated. Conclusion: This study evaluates the benefits of easily available Turk's fluid as a potent hemolyzing agent that can be used in all hemorrhagic thyroid aspiration smears, thereby avoiding repeat FNACs.


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