On-site cytotechnician evaluation of the adequacy of fine needle aspiration in a neck lump clinic

Abstract

In neck lump clinics where on-site cytopathology is not available, an on-site cytotechnician is a compromise measure that does reduce the number of inadequate FNAs.

Do Immediate Cytology and Specialist Radiologists Improve the Adequacy of Ultrasound‐Guided Fine‐Needle Aspiration Cytology?

“…6 Having a cytology technician as opposed to a cytopathologist has been shown to have comparable adequacy rates and so could be used as a less expensive alternative. 11 However, having an on-site cytologist can be important to give a preliminary diagnosis to the patient and allow more adequate patient counseling, thus improving patient satisfaction.…”

“…Adequacy rates with cytology support vary from 74% to 96%. [7][8][9][10][11][12] In this article, we have also looked at the benefits of having a head and neck subspecialist radiologist performing the ultrasound. We demonstrated an increase of 22% in the adequacy of FNAC with the presence of a subspecialist radiologist.…”

“…4,5 As part of the 1-stop clinics, the provision of on-site cytology has been proposed to increase the cost-effectiveness and diagnostic accuracy of ultrasound-guided FNAC by allowing the immediate assessment of sample adequacy and allowing a repeat aspirate to be taken if required. [6][7][8][9][10][11] However, this assertion has been disputed by some authors. For example, O'Malley et al 12 did not find a statistically significant difference in specimen adequacy between the FNAC of lesions (thyroid) undergoing immediate cytological analysis and those with delayed analysis, and they stated that immediate cytological analysis significantly prolonged the time of the FNAC procedure and actually reduced efficiency (12.5 minutes without cytology support vs 44.4 minutes with cytology support, P \ .01).…”