Fine-Needle Aspiration is Superior to Needle Core Biopsy as a Sample Aquisition Method for Flow Cytometric Analysis in Suspected Hematologic Neoplasms

Abstract

Background: Common minimally invasive methods for acquiring samples for flow cytometric immunophenotyping (FCI) include fine needle aspiration (FNA) and needle core biopsy (NCB). FCI requires a sufficient quantity of viable cells for adequate evaluation. Methods: We collected patient data from our files of all FCI cases sampled via FNA or NCB from 1/1/03 and 6/1/12. Total Viable Cells (TVC) was calculated by multiplying the volume, viability and concentration and then converted to logarithmic scale as "Log TVC." Statistical analysis was performed using SPSS. Results: 571 FCI cases at our institution were reviewed covering the period from 2003 to 2012 and 456 total cases were analyzed. 116 cases were sampled by NCB and 340 were sampled by FNA. Comparing FNA to NCB subgroups demonstrated FNA to be superior in mean specimen viability, TVC, and cases with a final FCI interpretation. The cellularity of the sample (in Log TVC) correlates with the likelihood of achieving a FCI interpretation. The point where at least 50% of cases have a diagnostic FCI interpretation occurs between Log TVC of 5.0 - 5.25. However, FNA based cases had a higher proportion of samples with an indeterminate final diagnosis. Conclusions: FNA was found to be significantly superior to NCB in obtaining material for FCI. However, NCB resulted in fewer indeterminate final diagnoses due to benefit of histologic correlation. In our opinion, NCB for histology combined with dedicated FNA material for FCI may yield the best results for a minimally invasive approach to the diagnosis of hematologic neoplasms. © 2014 Clinical Cytometry Society.

A Novel Approach to Classification and Reporting of Lymph Node Fine-Needle Cytology: Application of the Proposed Sydney System

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Fine needle aspirate flow cytometric phenotyping characterizes immunosuppressive nature of the mesothelioma microenvironment

“…Collection of guided fine needle aspirates (FNA) from tumors is a common clinical procedure that has been routinely utilized during the past 15–20 years. FNA have been shown to yield more viable cells than needle core biopsies, allowing for generation of single cell suspensions amenable to immediate flow cytometric analysis 8 . For this reason, they have been used with multiparametric flow cytometry as a method to augment the diagnosis of lymphoproliferative disorders, principally lymphomas, and report high concordance (over 95%) with conventional histopathological examination, which is considered the most rigorous methodology 9 10 11 .…”

Cellular point-of-care diagnostics using an inexpensive layer-stack microfluidic device

“…In these settings, FNA procedures can be ideal as they have lower complication rates than core biopsies and are generally very well-tolerated due to the use of smaller gauge needles (20–27 G). 1,2 Recent research has focused on developing automated pipelines for comprehensive analysis of FNA tumor samples. This has included development of cyclic staining methods for high multiplexing, 3,4 automated imaging systems 5 and AI-enabled software.…”