Introduction: Sputum cytology is a well-established technique for the detection of lung malignancies. Generally, random or morning samples are used. Objectives: To evaluate the diagnostic yield of morning sputum and compare it with that of fresh samples. Materials and Methods: Patients were instructed to bring a morning sputum sample to the laboratory in a clean plastic container, without any fixative and within 2-3 h of collection. Fresh sputum was then collected in the laboratory from these same patients. Two smears were prepared from each sample by the “pick and smear” technique and then stained by the Papanicolaou method. One hundred samples from each method (total 200 samples; 400 slides) were evaluated by 3 investigators for their adequacy, preservation, and yield of diagnostic cells. The results were analyzed by using the Pearson χ2 test. Results: Cytomorphological details were preserved in 82/84 satisfactory morning samples and in 80/81 satisfactory fresh samples, respectively. Malignancy was detected in 37 morning samples (44%) and 25 fresh samples (30.8%). In the malignant samples, there were more abundant tumor cells in the morning samples than in the fresh samples (65 and 40%, respectively) with a 2+ cellularity in the morning samples. The morning samples showed a better cell yield (25% more), with a 13% increase in the rate of detection of malignancy and an increased sensitivity of 19.68% compared to the fresh samples. Conclusions: Adequacy and preservation was similar in both sample types. While the morning samples showed a higher sensitivity and a larger number of tumor cells than the fresh samples, the difference was not statistically significant (p < 0.054).

Kennedy TC, Proudfoot SP, Piantadosi S, Wu L, Saccomanno G, Petty TL, Tockman MS: Efficacy of two sputum collection techniques in patients with air flow obstruction. Acta Cytol 1999;43:630-636.
Raab SS, Hornberger J, Raffin T: The importance of sputum cytology in the diagnosis of lung cancer: a cost-effectiveness analysis, Chest 1997;112:937-945.
Johnston W: Respiratory tract; in Bibbo M (ed): Comprehensive Cytopathology, ed 2. Philadelphia, WB Saunders, 2003, pp 325-326.
Rizzo T, Schumann GB, Riding JM: Comparison of the “pick and smear” and Saccomanno methods for sputum cytologic analysis. Acta Cytol 1990;34:875-880.
Suna E, Coskum O, Sevgi K: Sputum cytology for the diagnosis of lung cancer. Acta Cytol 2003;47:1023-1027.
Naib Z (ed): Respiratory Tract, ed 4. Boston, Little, Brown and Company, 1996, pp 219-221.
Mehta AC, Marty JJ, Lee FY: Sputum cytology. Clin Chest Med 1993;14:69-84.
Young JA: Techniques in pulmonary cytopathology. J Clin Pathol 1993;46:589-595.
Ammanagi AS, Dombale VD, Miskin AT, Dandagi GL, Sangolli SS: Sputum cytology in suspected cases of carcinoma of lung (Sputum cytology a poor man's bronchoscopy!). Lung India 2012;29:19-23.
Jay SJ, Wehr K, Nikolson DP, Smith AL: Diagnostic sensitivity and specificity of pulmonary cytology: comparison of techniques used in conjunction with flexible fiber-optic bronchoscopy. Acta Cytol 1980;304-312.
Truong LD, Underwood RD, Greenberg SD, McLarty JW: Diagnosis and typing of lung carcinomas by cytopathologic methods - a review of 108 cases. Acta Cytol 1985;29:379-384.
Tsang KW, Bentley AM, Mann JS, Belcher J, Pantin CF: Survey of outpatient sputum cytology: influence of written instructions on sample quality and who benefits from investigation. Qual Health Care 1992;1:48-50.
Liang XM: Accuracy of cytologic diagnosis and cytotyping of sputum in primary lung cancer: analysis of 161 cases. J Surg Oncol 1989;40:107-111.
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