Cytorich fixative system- A new modality in haemorrhagic fine needle aspiration smears

Introduction: The CytoRich Red fixative system for red blood cell lysis in liquid based cytology technique is quite effective in hemorrhagic cervical PAP smears. However, its role in fine needle aspiration cytology needs to be explored. Aims and Objectives: (1). Highlight the role of CytoRich Red fluid as fixative media. (2). To compare CytoRich Red fixed smear with conventional smear. (3). To compare CytoRich Red fixed smear with liquid based cytology (LBC) smear. Material and Methods: Thirty hemorrhagic smears from breast (16 ) , thyroid (08), lymph node (04) and soft tissue (02) lesions were included in the study. The fine needle aspirate was divided into two parts. First part was used for conventional smears and CytoRich Red treated smears. An unstained smear was stored in cold acetone for immunocytochemistry, which was applied on relevant cases. The second part was used for Liquid-Based cytology (LBC). All smears were compared for cytomorphological features and background material. The smears were classified into 3 groups based on the percentage of hemorrhage that is 25-50% and >50%. Statistical analysis was done by SPSS version 24. A p value of 0.05 was considered as significant. Results: Red blood cells were significantly reduced without hindering staining with a statistically significant difference between background haemorrhage in conventional smears and CytoRich Red treated smears (p value smears and LBC. The Diagnostic utility of CytoRich Red treated smears was more than that of LBC alone (p value Conclusion: Cytorich red fixative system can be used in case of hemorrhagic fine needle aspiration slide which provides a clear background without compromising the cellularity of the smears. Keywords: Hemorrhagic smears, CytoRich Red, Fine needle aspiration cytology, Liquid-Based cytology, Immunocytochemistry