The Significance of “Positive” Respiratory Cytology Determinations in a Series of 327 Patients

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Abstract
The authors reviewed all “positive” respiratory cytology diagnoses rendered over the past ten years at a medical center. Three hundred twenty-seven patients (with a total of 689 “positive” respiratory cytology determinations) were classified as having nonmalignant or malignant respiratory tract disease by using a unique system of explicit, reproducible verification criteria. Five patients with false-positive results (1.5%) and seven false-positive patient determinations (1.0%) were encountered. None of these were typed cytologically as small cell anaplastic carcinoma, and none were bronchial determinations. Overall patient typing accuracy was 72.2%; 75.2% of all sputum and 61.2% of all bronchial determinations were typed accurately. Our lowest typing accuracy (53.3%) was encountered in patients with poorly differentiated carcinoma. The findings from this study confirm the continued need for systematic analysis of respiratory cytology data from large groups of patients. Only then can cytopathologists hope to improve upon the clinical value of this diagnostic modality.