Utility of White Blood Cell Diluting Fluid (Turk’s Fluid) in Evaluation of Haemorrhagic Thyroid Cytology Smears in a Tertiary Care Centre- A Novel Study

Introduction: Fine Needle Aspiration Cytology (FNAC) has been one of the safest and accurate diagnostic technique in diagnosing thyroid lesions. But due to the vascularity of thyroid tissue, diagnostic cells get entrapped in blood clot unless rapid smearing is done.This results in repeat FNAC which is inconvenient to the patient as well as time consuming to pathologist. Therefore, an alternative is required to avoid repeat FNAC procedure.

Aim: To evaluate the role of Turk’s fluid in haemorrhagic thyroid FNAC smears in comparison to conventional haemorrhagic smears.

Materials and Methods: The present study was a prospective observational study, which was conducted for the period of six months (March-August 2021). A total of 30 cases were included in the study. Fine Needle Aspiration (FNA) sampling was done on patients with thyroid swelling. After the needling was done on the swelling, four smears were prepared. One was stained using haematoxylin and eosin (H&E). Rest of all the smears were stained by Conventional Giemsa (CG) method. One of these CG stained smears was immediately treated with Turk’s fluid for 10-20 seconds. The CG stained smears were compared with the Turk’s fluid Treated Giemsa (TTG) smears and evaluated for retention of Red Blood Cells (RBCs), visibility of nuclear and cytoplasmic details of thyroid follicular cells.

Results: A total of 30 cases were included in the study. The retention of RBC was lesser in TTG compared to CG which was statistically significant (p-value <0.05). The visibility of cytoplasmic and nuclear morphology on TTG was better than that of CG which was statistically significant (p-value <0.05).

Conclusion: The TTG smears improves visibility of cytomorphological features by reducing background RBCs and hence avoids repeat FNAC.