Role and accuracy of rapid on‐site evaluation of CT‐guided fine needle aspiration cytology of lung nodules

Fassina, Ambrogio; Corradin, Matteo; Zardo, Davide; Cappellesso, Rocco; Corbetti, Francesco; Fassan, Matteo

doi:10.1111/j.1365-2303.2010.00802.x

Cited by 72 publications

(73 citation statements)

References 35 publications

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“…[6] It may also yield preliminary diagnosis especially in distinguishing between nonneoplastic and neoplastic, if not the precise categorization, for lung lesions. [7] In the present study also preliminary distinction between neoplastic and non-neoplastic was possible on ROSE in a fair number of cases but the final diagnosis was given only after microscopic examination of routine conventional smears [Figure 2]. …”

Section: Discussionmentioning

confidence: 75%

“…The close and vigilant appreciation of morphological features according to the set criteria may be highly useful for cytological differentiation of SCC and AdCa. [7] The Papanicolaou (Pap) staining for demonstrating keratinization and observation of acini and three dimensional clusters can be useful in this regard. Previous studies have also observed that Pap staining on cytological smears may highlight even minimal keratinization in comparison to hematoxyline and eosin staining of histological sections for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Role of rapid on-site evaluation with cyto-histopathological correlation in diagnosis of lung lesion

Chandra

Sindhwani

2014

J Cytol

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Aim:This study was conducted to assess the role of cytology in the diagnosis of lung lesions and to compare it with histopathology. It was also intended to evaluate the role of rapid on site evaluation (ROSE) as an adjunct to cytological diagnosis of lung lesions.Materials and Methods:The study included all the cases of lung lesions, which were diagnosed on cytology followed by histopathology over a period of 2½ years along with ROSE, wherever possible.Results:Cytology was done in total 782 cases of various lung lesions and of this cyto-histopathological correlation was available in 215 cases. ROSE was done in 93.4% of total cases and smears were considered on the site adequate in the first pass in 68.1% cases and in second pass adequacy increased to 93.4%. The diagnostic accuracy of cytology was 75.3%, and that of histology was 86.9% in the diagnosis of lung lesions. The diagnostic accuracy of cytology for squamous cell carcinoma (94.4%) and adenocarcinoma (96.5%) was higher than that of histology.Conclusion:Cytology is comparable to histology in the diagnosis of lung lesions and may even outperform biopsy in lung tumor diagnosis. The advantages of cytology may be further added by better sampling and preanalytical assessment for adequate diagnostic material and ROSE has proved to be an important, easy and cost effective adjunct in this regard. A multidisciplinary approach involving pulmonologist, radiologist and cytopathologist with ROSE, followed by vigilant morphological examination may increase diagnostic utility of cytology for lung lesions.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Role of rapid on-site evaluation with cyto-histopathological correlation in diagnosis of lung lesion

Chandra

Sindhwani

2014

J Cytol

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“…[7] The use of TIC as an adjunct to CNB, not only improves the accuracy of diagnosis[61115] but decreases patient exposure to unnecessary further intervention and discomfort. [711121314151617] Whereas tissue fixation, sectioning and further evaluation may take 24-48 h,[9] TIC would provide the physician with a preliminary diagnosis in mere 1-2 min, enabling for a more rapid initiation of ancillary testing.…”

Section: Discussionmentioning

confidence: 99%

Impact of immediate evaluation of touch imprint cytology from computed tomography guided core needle biopsies of mass lesions: Single institution experience

et al. 2014

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Background:Computed tomography (CT) guided core needle biopsy (CT-guided CNB) is a minimally invasive, safe and effective manner of tissue sampling in many organs. The aim of our study is to determine the impact of on-site evaluation of touch imprint cytology (TIC) to minimize the number of passes required to obtain adequate tissue for diagnosis.Design:A retrospective review of all CT-guided CNBs performed during 4 year period, where pathologists were present for on-site TIC evaluation. Each case was evaluated for the number of passes required before TIC was interpreted as adequate for diagnosis.Results:A total of 140 CT-guided CNBs were included in the study (liver, lung, kidney, sacral, paraspinal, omental, splenic and adrenal masses). Of the 140 cases, 109 were diagnosed as malignant, 28 as benign and three insufficient. In 106 cases (75.7%), the biopsies were determined adequate by TIC on the first pass, 19 cases (13%) on the second pass and 7 cases (5%) on the third pass. Only in 5 cases (3.6%), more than three passes were required before diagnostic material was obtained. Three cases (2.14%) were interpreted as inadequate both on TIC and on the final diagnosis. Of the biopsies deemed adequate on the first pass, 71% resulted in either termination of the procedure, or only one additional pass was obtained. In five cases, based on the TIC evaluation, a portion of the sample was sent for either flow cytometric analysis or cytogenetic studies.Conclusions:In the majority of cases, adequate material was obtained in the first pass of CT-guided CNB and once this was obtained, either no additional passes, or one additional pass was performed. This study demonstrates the utility of on-site evaluation in minimizing the number of passes required for obtaining adequate diagnostic material and for proper specimen triage for ancillary studies, which in turn decreases the risk to the patient and costs. However, tumor exhaustion in the tissue as a result of TIC is an important pitfall of the procedure, which occurred in 9 (8.2%) of our malignant cases.

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“…[5][6][7][8][9] Rapid on-site cytologic evaluation informs the operator for need to obtain additional samples and increases diagnostic yield. 10 On average, ROSE improves the per-case adequacy rate by about 12%.…”

Section: Number Of Passesmentioning

confidence: 99%

Unveiling mediastinal pathology: role of EUS guided fine needle aspiration in diagnosing mediastinal lesions

2018

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Background: Mediastinal lesion is the focus of investigation in diagnosis of infective, granulomatous or neoplastic pathology of respiratory system. Metastatic mediastinal node assessment is an integral part of oncological management. EUS provides access to sampling of mediastinal mass, sub-carinal and aorto-pulmonary nodes. This study aims to assess the clinical impact, diagnostic yield and safety of EUS guided FNA for mediastinal lesions.Methods: Retrospective analysis of prospectively collected data of 72 cases of mediastinal lesions between January 2014 and December 2017 was done. EUS-FNA was performed with a linear echoendoscope using a 22- or 25-gauge needle. Adequacy of cellularity was assessed by on site pathologist. Patient data (demographics, intervention and follow-up) were prospectively collected and introduced in a predefined computer database for later review.Results: EUS-FNA was performed from 57 lymph nodes and 15 mediastinal masses. Adequate samples were obtained in 67 of 72 patients (93.05%). All mediastinal masses were malignant and were identified in the 3rd, 5th and 6th decade of life. Of the 57 lymph nodes, 15 were malignant, 28 had granulomatous lymphadenitis of which 16 individuals became asymptomatic after anti tubercular therapy. Sample was inadequate in 5 circumstances. No major complications were encountered with the procedure in any of the individuals.Conclusions: EUS guided tissue diagnosis is a safe technique and our data supports the use of EUS-FNA in work-up of mediastinal lesions. It is minimally invasive, accurate and has easy access to mediastinum. It has significant impact on patient diagnosis, management and should be considered over other invasive techniques.

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Role and accuracy of rapid on‐site evaluation of CT‐guided fine needle aspiration cytology of lung nodules

Cited by 72 publications

References 35 publications

Role of rapid on-site evaluation with cyto-histopathological correlation in diagnosis of lung lesion

Role of rapid on-site evaluation with cyto-histopathological correlation in diagnosis of lung lesion

Impact of immediate evaluation of touch imprint cytology from computed tomography guided core needle biopsies of mass lesions: Single institution experience

Unveiling mediastinal pathology: role of EUS guided fine needle aspiration in diagnosing mediastinal lesions

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