The blue magic in aspiration cytology: unfolding the role of toluidine blue. A hospital-based cross-sectional prospective observational study.

Velusamy  Nathiyal; Dr. Ragavi  Venkataramanan; Heera S

doi:10.51168/sjhrafrica.v7i3.2535

Authors

Dr. Velusamy Nathiyal Assistant Professor, PSP Medical College Hospital & Research Institute, Oragadam, Kanchipuram, India
Dr. Ragavi Venkataramanan Assistant professor, St. Peters Medical College Hospital and Research Institute, Hosur, India.
Dr. Heera S Assistant professor, St. Peters Medical College Hospital and Research Institute, Hosur, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2535

Keywords:

Fine Needle Aspiration Cytology, Toluidine Blue, Rapid On-Site Evaluation, Supravital Stain, Diagnostic Accuracy

Abstract

Background:

Fine Needle Aspiration Cytology (FNAC) is a widely used diagnostic technique. However, inadequate sampling may compromise diagnostic accuracy. Rapid on-site evaluation (ROSE) using supravital stains such as Toluidine Blue may improve smear adequacy and efficiency.

Aim:

To assess the role of Toluidine Blue Stain (TBS) in on-site adequacy evaluation of FNAC smears and to compare its diagnostic accuracy with Leishman Stain (LS) and Rapid Papanicolaou Stain (RPS).

Materials and Methods:

This hospital-based cross-sectional prospective observational study included 179 consecutive FNAC cases from various anatomical sites. One unfixed smear per case was stained with 1% TBS for immediate adequacy assessment, while additional smears were stained with LS and RPS for cytomorphological comparison.

Results:

Adequacy with TBS was 97.8% on first aspiration and 100% after re-aspiration. Diagnostic accuracy was 100% for TBS, 97.8% for LS and 82.1% for RPS. TBS provided satisfactory nuclear and cytoplasmic detail across diverse lesions.

Conclusion:

TBS is a rapid, economical and reliable staining technique that enhances on-site adequacy and diagnostic efficiency in routine FNAC practice.

Recommendation:

It is recommended that TBS be integrated into routine FNAC workflow, particularly in high-volume and resource-limited settings, to reduce inadequate sampling rates and improve diagnostic turnaround time. Further large-scale multicentric studies with histopathological correlation are recommended to validate these findings.

Author Biographies

Dr. Velusamy Nathiyal, Assistant Professor, PSP Medical College Hospital & Research Institute, Oragadam, Kanchipuram, India

MBBS, MD Pathology, is an Assistant Professor in the Department of Pathology at PSP Medical College Hospital & Research Institute, Oragadam, Kanchipuram, India. His research interests include cytopathology and diagnostic hematology.

Dr. Ragavi Venkataramanan, Assistant professor, St. Peters Medical College Hospital and Research Institute, Hosur, India.

MD Pathology, is an Assistant Professor in the Department of Pathology at St. Peter's Medical College Hospital and Research Institute, Hosur, India. Her research interests include oncopathology and cytodiagnosis.

Dr. Heera S, Assistant professor, St. Peters Medical College Hospital and Research Institute, Hosur, India.

MD Pathology, is an Assistant Professor in the Department of Pathology at St. Peter's Medical College Hospital and Research Institute, Hosur, India. Her research interests include gynecological pathology and cytology.

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