Petals of rose: Application of rapid on-site evaluation in bronchoscopy

Authors

  • Sayan Bhowmik
  • Thanka J.
  • Aswin Manikandan
  • Sabarinath Ravichandar

DOI:

https://doi.org/10.51248/.v42i5.1783

Keywords:

Bronchoscopy, ROSE, Diagnosis

Abstract

In present day scenario, procedures that are minimally invasive like FNAs and Core needle biopsies are on the rise. Rapid on-site evaluation (ROSE) is a laboratory service that assesses the cytomorphologic features from FNA smears or biopsy contact imprints in the biopsy room and can provide on the spot input and suggestions for the clinician through immediate cytological examination of the biopsy sample. ROSE also allows for a preliminary diagnosis, allowing for the requirement of additional material for ancillary studies. We are presenting two cases which highlights the merits of ROSE in cytological diagnosis.

 

In the first case, a thirty four year old male patient came with complaints of productive cough, breathlessness and fever. Bronchoscopic needle aspiration and biopsy was done with Rapid Onsite Evaluation. ROSE revealed two non-caseating epithelioid granulomas on the 4th pass. Bronchoscopic lymph node biopsy was non- contributory. With other clinical and biochemical parameters, diagnosis of Sarcoidosis was made. This case study underscores the significance of ROSE in arriving at the diagnosis.

 

In the other case, a fifty seven year old male patient came to hospital with productive cough and breathlessness (MMRC grade II). CT chest revealed features suggestive of bronchogenic carcinoma. ROSE was performed along with bronchial brush cytology in which presence of atypical cells with increased nuclear cytoplasmic ratio, nuclear hyperchromatism and nuclear molding was noted. On histopathological examination, it was diagnosed as a case of non-small cell carcinoma of lung – poorly differentiated type. This case proves the advantage of ROSE in avoiding repeated invasive procedures for the patient.

Author Biographies

Sayan Bhowmik

Department of Pathology, Sree Balaji Medical College, and Hospital, Chromepet, Chennai, 600044, Tamil Nadu, India

Thanka J.

Department of Pathology, Sree Balaji Medical College, and Hospital, Chromepet, Chennai, 600044, Tamil Nadu, India

Aswin Manikandan

Department of Pathology, Sree Balaji Medical College, and Hospital, Chromepet, Chennai, 600044, Tamil Nadu, India

Sabarinath Ravichandar

Department of Respiratory Medicine, Sree Balaji Medical College, and Hospital, Chromepet, Chennai, 600044, Tamil Nadu, India

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Published

2022-11-14

How to Cite

1.
Bhowmik S, J. T, Manikandan A, Ravichandar S. Petals of rose: Application of rapid on-site evaluation in bronchoscopy. Biomedicine [Internet]. 2022 Nov. 14 [cited 2022 Nov. 27];42(5):1098-102. Available from: https://biomedicineonline.org/home/article/view/1783

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