The international system for reporting serous fluid cytopathology: The initial project survey

Objective: An international panel in the field of body fluid cytology, supported by the International Academy of Cytology and the American Society of Cytopathology, conducted a survey to identify opinions and explore existing practice patterns regarding body fluid cytopathology. Methods: The study group, formed during the 2018 European Congress of Cytology in Madrid, generated a survey of 54 questions related to the practice and taxonomy of body fluid cytology. The survey was available online from 28 August 2018 until 10 December 2018. Participants were invited through the websites and listserves of the professional societies. Results: The survey collected 593 international participant responses. Questions pertained to practice patterns and diagnostic language. Information was collected regarding credentials, work setting, work volume (4-10,000 samples) and years in practice (0-60 years). The responses revealed variations in diagnostic practice and sample management. Direct smears and ThinPrep® preparations are the most popular methods, followed by Cytospin® and SurePath®. Most (70%) respondents perform ancillary studies on their material, with over 50% preferring a cell block preparation. Approximately 32% indicated that they are capable of performing genetic studies on the samples. Nearly 78% of participants would accept a two-stage cytology report, with a preliminary assessment followed by a final diagnosis that accounts for ancillary studies to generate a more precise cytological interpretation. Approximately one-third (36%) never report adequacy on body fluid samples. Most (78%) report a general category result (negative, atypical, suspicious, or positive) and 22% provide a detailed surgical pathology type report. Most (73.6%) participants believe that both Papanicolaou stains and a modified Giemsa stain (eg Diff Quik) should be standard preparations for all serous fluid cytology. Conclusions: The results of the survey demonstrated strong support for the development of a unified system for reporting body fluid cytopathology among respondents.