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

Abstract

INTRODUCTIONThe gold standard for assessing neck lumps is a one-stop clinic with an on-site cytopathologist who can provide an immediate fine needle aspiration (FNA) report. However, this has considerable resource implications and is not available in all units. In our department, surgeons perform FNAs guided by palpation. The FNA is evaluated for specimen adequacy by an on-site cytotechnician. This study evaluated the impact of the cytotechnician on the adequacy of neck lump FNA. METHODS FNA performed between June 2010 and February 2012 was examined. The FNA performed at a neck lump clinic with an assessment of adequacy by an on-site cytotechnician were considered the test group. All other neck lump FNAs from other sources without an assessment of adequacy by an on-site cytotechnician were considered the control group. RESULTS Of the FNAs, 134 met the inclusion criteria for this study. Of these, 87 FNAs (65%) were analysed for adequacy by the on-site cytotechnician and the remaining 47 (35%) were not. The results demonstrated an FNA inadequacy with and without on-site cytotechnician assessment of 29.9% and 40.4% respectively. This is equivalent to an absolute risk reduction of an inadequate FNA of 10.5%, which equates to a number needed to treat of 9.5, ie the cytotechnician needs to assess 9.5 (ie the cytotechnician [...] specimen). CONCLUSIONS 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.

Evaluation of fine needle aspiration biopsy in oral cavity and head and neck region with different stains techniques

“…This reflects Many studies emphasize the presence of a pathologist at the time of collection or a cytotechnologist (capable of collecting and viewing the sample at the same time), demonstrating that these professionals are essential and accuracy of the technique reaches high levels, making it reliable for diagnostic, helping to decrease the time between diagnosis and treatment. 7,14,15 There were no false positive or false negative in our analysis as demonstrated by a few cases in the literature. 5,16 Despite being something positive from the analysis, it turned to be difficult to calculate sensitivity and specificity as reported, and did not reflect the truth in the study.…”

Accuracy of non-ultrasound guided thyroid gland fine needle aspiration with biopsy

“…This procedural algorithm is slow moving, inconvenient, costly, and inherently disadvantageous to timely diagnosis [10]. It has been long acknowledged by endocrinologists and otolaryngologists alike that the most appropriate and effective method of evaluating a thyroid mass is via the FNAC technique, because it is quick, safe, cheap, and usually accurately yields the cytological characteristics of the tissue samples [11].…”

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.…”

“…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).…”