1. Diagnosis of visceral pleural invasion by lung cancer using intraoperative touch cytology 
Yushi Saito, MD, PhD, Yosuke Yamakawa, MD, PhD, Masanobu Kiriyama, MD, PhD, Ichiro Fukai, MD, PhD, Satoshi Kondo, MD, PhD, Masahiro Kaji, MD, Motoki Yano, MD, Tomoki Yokoyama, MD, Yoshitaka Fujii, MD, PhD 
The Annals of Thoracic Surgery 
Volume 73, Issue 5, Pages (May 2002)
DOI: /S (02)

2. Fig 1
The technique of touch cytology was used to detect visceral pleural invasion of a tumor. Immediately after thoracotomy, the pleura overlying the tumor was gently touched by a piece of glass slide. This was repeated five times. Care was taken not to scrub the surface.
The Annals of Thoracic Surgery  , DOI: ( /S (02) )

3. Fig 2
Pathologic findings of representative patients. Hematoxylin & eosin (HE) staining: (A), (C), (E), and (G). Elastic fiber staining (blue): (C), (E), and (G). Touch cytology: (B), (D), and (F). (A) and (B) show a p2 patient. (A) HE staining shows lung cancer invading the pleura (arrow). (B) Touch cytology shows tumor cells (arrow) among mesothelial cells. (C) and (D) show a p1 patient. In (C) the tumor cells apparently invade the elastic lamina (arrow), but they do not seem to be exposed to the surface, which is covered by a thick fibrous tissue thus leading to a diagnosis of p1. In this patient, touch cytology shows many clusters of malignant cells (arrow) as shown in (D). (E) and (F) show a p0 patient with no pleural involvement as shown by the blue elastic stain, (E). However, in (F) a few malignant cells (arrow) are found in the touch cytology specimens among mesothelial cells. (G) A case with pleural invasion (arrow) at the bottom of a deep groove made by the pleural retraction. No tumor cells could be identified by touch cytology in this patient (not shown).
The Annals of Thoracic Surgery  , DOI: ( /S (02) )