scholarly journals Cell Block: A Tool to Improve Cytopathologic Diagnostic Value of Fine Needle Aspiration Material

2020 ◽  
Vol 7 (7) ◽  
pp. A366-374
Author(s):  
Vaishali Baburao Nagose ◽  
Shruthi Amit Deshpande ◽  
Dinesh Kasturi ◽  
Varsha Ashok Jadhav
Keyword(s):  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Diagnostic Value ◽  
Needle Aspiration ◽  
Care Hospital ◽  
Cell Block ◽  
Fine Needle ◽  
Medical College ◽  
Sensitivity Specificity

Background: The various advantages of Fine-needle aspiration (FNA) biopsy/ cytology can be limited due to inadequacy of the specimen and expertise required for diagnosis. Cell blocks (CBs), though routinely used in cytology of body fluids, can also be used in FNA material with considerable increase in diagnostic accuracy. Aims & objectives: To compared FNA & CB as diagnostic tool and to evaluate whether cell block adds to the diagnostic accuracy of FNA. Methods: This is a two years prospective study carried out in the pathology department of a tertiary heath care hospital and medical college of South India which included the cases undergoing the FNAC, and followed by the biopsy. CB was prepared using Tissue coagulum clot (TCC) method. The smears and tissue sections were assessed for cellularity and adequacy for diagnosis. CBs were grouped into four diagnostic categories. FNA & CB were compared with histopathology (HPE) diagnosis to calculate Sensitivity, Specificity and Diagnostic Accuracy. Result: A total of 195 cases were included. Cellularity and adequacy for diagnosis were higher in CB. They were diagnostically better (superior) in 13.84% (27) cases. The sensitivity (95.77%) and diagnostic accuracy (94.87%) of CB was found to be considerably higher than FNA (78.84% and 78.46% respectively). Conclusion: In cases of suspicious/ intermediate diagnosis or diagnosis discordant with clinical ones, by FNA; should be followed with the CB to improve the diagnostic yield & to facilitate accurate diagnoses. TCC method is a simple CB method which has higher diagnostic accuracy than FNA.

scholarly journals Diagnostic yield and agreement on fine-needle specimens from solid pancreatic lesions: comparing the smear technique to liquid-based cytology

2020 ◽  
Vol 08 (02) ◽  
pp. E155-E162 ◽  
Author(s):  
Priscilla A. van Riet ◽  
Rutger Quispel ◽  
Djuna L. Cahen ◽  
Mieke C. Snijders-Kruisbergen ◽  
Petri van Loenen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Yield ◽  
Diagnostic Value ◽  
Needle Aspiration ◽  
Cell Block ◽  
Pancreatic Lesion ◽  
Fine Needle ◽  
Site Evaluation ◽  
Liquid Based Cytology ◽  
Solid Lesions

Abstract Background and study aims The traditional “smear technique” for processing and assessing endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is sensitive to artifacts. Processing and evaluation of specimens collected in a liquid medium, liquid-based cytology (LBC) may be a solution. We compared the diagnostic value of EUS-FNA smears to LBC in pancreatic solid lesions in the absence of rapid on-site evaluation (ROSE). Patients and methods Consecutive patients who required EUS-FNA of a solid pancreatic lesion were included in seven hospitals in the Netherlands and followed for at least 12 months. Specimens from the first pass were split into two smears and a vial for LBC (using ThinPrep and/or Cell block). Smear and LBC were compared in terms of diagnostic accuracy for malignancy, sample quality, and diagnostic agreement between three cytopathologists. Results Diagnostic accuracy for malignancy was higher for LBC (82 % (58/71)) than for smear (66 % (47/71), P = 0.04), but did not differ when smears were compared to ThinPrep (71 % (30/42), P = 0.56) or Cell block (62 % (39/63), P = 0.61) individually. Artifacts were less often present in ThinPrep (57 % (24/42), P = 0.02) or Cell block samples (40 % (25/63), P < 0.001) than smears (76 % (54/71)). Agreement on malignancy was equally good for smears and LBC (ĸ = 0.71 versus ĸ = 0.70, P = 0.98), but lower for ThinPrep (ĸ = 0.26, P = 0.01) than smears. Conclusion After a single pass, LBC provides higher diagnostic accuracy than the conventional smear technique for EUS-FNA of solid pancreatic lesions in the absence of ROSE. Therefore, LBC, may be an alternative to the conventional smear technique, especially in centers lacking ROSE.

scholarly journals EUS-guided fine needle biopsy alone vs. EUS-guided fine needle aspiration with rapid on-site evaluation of cytopathology in pancreatic lesions: a multicenter randomized trial

Endoscopy ◽  
2021 ◽  
Author(s):  
Yen-I Chen ◽  
Avijit Chatterjee ◽  
Robert Berger ◽  
Yonca Kanber ◽  
Jonathan M Wyse ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Procedure Time ◽  
Fine Needle ◽  
Site Evaluation ◽  
Sensitivity Specificity ◽  
Solid Lesions

Background and Study Aims: EUS-guided fine needle aspiration (EUS-FNA) is the standard in the diagnosis of pancreatic solid lesions, in particular when combined with rapid on-site evaluation of cytopathology (ROSE). More recently, a fork-tip needle for core biopsy (FNB) has been shown to be associated with excellent diagnostic yield. EUS-FNB alone; however, has not been compared to EUS-FNA+ROSE in a large clinical trial. Our aim is to compare EUS-FNB alone to EUS-FNA+ROSE in solid pancreatic lesions. Patients and Methods: Multicenter non-inferiority RCT involving 7 centers. Solid pancreatic lesions referred for EUS were considered for inclusion. The primary endpoint is diagnostic accuracy. Secondary endpoints include sensitivity/specificity, mean number of needle passes, and cost. Results: 235 patients were randomized: 115 EUS-FNB alone and 120 EUS-FNA+ROSE. Overall, 217 patients had a malignant histology. The diagnostic accuracy for malignancy of EUS-FNB alone was non-inferior to EUS-FNA+ROSE 92.2% (95% CI: 86.6-96.9%) and 93.3% (95% CI: 88.8-97.9%), respectively p=0.72. Diagnostic sensitivity for malignancy was 92.5% (95% CI: 85.7-96.7%) EUS-FNB alone vs. 96.5% (93.0-98.6%) EUS-FNA+ROSE (p=0.46) while specificity was 100% in both. Adequate histology yield was obtained in 87.5% of the EUS-FNB alone samples. Mean number of needle of passes and procedure time favored EUS-FNB alone (2.3±0.6 passes vs. 3.0±1.1 passes p≤0.01 and 19.3±8.0 minutes vs. 22.7±10.8 minutes p <0.01). EUS-FNB alone cost on average 45USD more than EUS-FNA+ROSE. Conclusion: EUS-FNB alone is non-inferior to EUS-FNA+ROSE and is associated with fewer needle passes, shorter procedure time, and excellent histological yield at comparable cost. (clinicaltrials.gov: NCT03435588).

scholarly journals Evaluation of endoscopic ultrasound fine-needle aspiration versus fine-needle biopsy and impact of rapid on-site evaluation for pancreatic masses

2020 ◽  
Vol 08 (06) ◽  
pp. E738-E747 ◽  
Author(s):  
Diogo T.H. de Moura ◽  
Thomas R. McCarty ◽  
Pichamol Jirapinyo ◽  
Igor B. Ribeiro ◽  
Kelly E. Hathorn ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Cell Block ◽  
Fine Needle ◽  
Pancreatic Masses ◽  
Site Evaluation ◽  
Sensitivity Specificity

Abstract Background and study aims Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is traditionally considered a first-line strategy for diagnosing pancreatic lesions; however, given less than ideal accuracy rates, fine-needle biopsy (FNB) has been recently developed to yield histological tissue. The aim of this study was to compare diagnostic yield and safety between EUS-FNA and EUS-FNB in sampling of pancreatic masses. Patients and methods This was a multicenter retrospective study to evaluate efficacy and safety of EUS-FNA and EUS-FNB for pancreatic lesions. Baseline characteristics including sensitivity, specificity, and accuracy, were evaluated. Rapid on-site evaluation (ROSE) diagnostic adequacy, cell-block accuracy, and adverse events were analyzed. Subgroup analyses comparing FNA versus FNB route of tissue acquisition and comparison between methods with or without ROSE were performed. Multivariable logistic regression was also performed. Results A total of 574 patients (n = 194 FNA, n = 380 FNB) were included. Overall sensitivity, specificity, and accuracy of FNB versus FNA were similar [(89.09 % versus 85.62 %; P = 0.229), (98.04 % versus 96.88 %; P = 0.387), and 90.29 % versus 87.50 %; P = 0.307)]. Number of passes for ROSE adequacy and cell-block accuracy were comparable for FNA versus FNB [(3.06 ± 1.62 versus 3.04 ± 1.88; P = 0.11) and (3.08 ± 1.63 versus 3.35 ± 2.02; P = 0.137)]. FNA + ROSE was superior to FNA alone regarding sensitivity and accuracy [91.96 % versus 70.83 %; P < 0.001) and (91.80 % versus 80.28 %; P = 0.020)]. Sensitivity of FNB + ROSE and FNB alone were superior to FNA alone [(92.17 % versus 70.83 %; P < 0.001) and (87.44 % versus 70.83 %; P < 0.001)]. There was no difference in sensitivity though improved accuracy between FNA + ROSE versus FNB alone [(91.96 % versus 87.44 %; P = 0.193) and (91.80 % versus 80.72 %; P = 0.006)]. FNB + ROSE was more accurate than FNA + ROSE (93.13 % versus 91.80 %; P = 0.001). Multivariate analysis showed ROSE was a significant predictor of accuracy [OR 2.60 (95 % CI, 1.41–4.79)]. One adverse event occurred after FNB resulting in patient death. Conclusion EUS-FNB allowed for more consistent cell-block evaluation as compared to EUS-FNA. EUS-FNA + ROSE was found to have a similar sensitivity to EUS-FNB alone suggesting a reduced need for ROSE as part of the standard algorithm of pancreatic sampling. While FNB alone produced similar diagnostic findings to EUS-FNA + ROSE, FNB + ROSE still was noted to increase diagnostic yield. This finding may favor a unique role for FNB + ROSE, suggesting it may be useful in cases when previous EUS-guided sampling may have been indeterminate.

scholarly journals A comparative study of fine-needle aspiration cytology and histopathology in salivary gland lesions

1970 ◽  
Vol 1 (2) ◽  
pp. 108-113 ◽  
Author(s):  
S Vaidya ◽  
A Sinha ◽  
S Narayan ◽  
S Adhikari ◽  
KC Sabira
Keyword(s):  
Salivary Gland ◽  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Neoplastic Lesions ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Background: A wide variety of benign and malignant tumours originate in the salivary glands and insufficient tumour cells make their diagnosis difficult in some patients. The aim of this study was to evaluate the efficacy of fine-needle aspiration cytology in the diagnosis of salivary gland lesions and to correlate cytological findings with histopathology. Materials and Methods: This was a prospective study done from September 2002 to May 2004. Fine needle aspiration cytology was performed in 58 patients with clinically significant salivary gland masses. Results: Fine needle aspiration cytology categorized 67.24% of the salivary gland lesions as neoplastic and 32.76% as non-neoplastic lesions. Amongst the neoplastic lesions, 76.9% were benign and 23.1% were malignant cases. Histopathological examination revealed that 81.05% of the cases were benign and 18.95% were malignant. Fine needle aspiration cytology had a sensitivity, specificity and diagnostic accuracy of 81.82%, 100% and 96.55%, respectively. The positive predictive value and negative predictive value was 100% and 95.9%, respectively. Conclusion: Fine needle aspiration of the salivary gland is a safe and reliable technique in the primary diagnosis of salivary gland lesions. Although, limitations are encountered while predicting specific lesions on cytology, especially when dealing with cystic and some malignant lesions, this study has shown that fine needle aspiration cytology has a high sensitivity, specificity and diagnostic accuracy in diagnosing salivary gland lesions. Keywords: Salivary glands; Fine needle aspiration cytology; Histopathology DOI: http://dx.doi.org/10.3126/jpn.v1i2.5403 JPN 2011; 1(2): 108-113

scholarly journals Pull vs. wet: rendimiento diagnóstico y calidad de las muestras de las PAAF guiadas por USE en las masas sólidas del páncreas

2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Cecilia Curvale ◽  
Ignacio Málaga ◽  
Paloma Rojas Saunero ◽  
Viviana Tassi ◽  
Enrique Martins ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Double Blind Study ◽  
Cell Block ◽  
Ultrasound Guided ◽  
Double Blind ◽  
Fine Needle ◽  
Significant Difference

Differential diagnosis of pancreatic masses is challenging. The endoscopic ultrasound-guided fine-needle aspiration method with the highest diagnostic yield has not been established. It was realized a prospective, randomized, double-blind study of the endoscopic ultrasound-guided fine-needle aspiration in solid lesions of the pancreas to compare and evaluate diagnostic yield and aspirate quality between wet and pull technique. Forty-one patients were enrolled. The wet technique presented a sensitivity, a specificity, a positive and negative predictive value, and a diagnostic accuracy of 58.3%, 100%, 100%, 25% and 63.4%, respectively. In the capillary technique they were: 75%, 100%, 100%, 35.7% and 78.1%, respectively. Comparing the diagnostic yield between both techniques, there was no statistically significant difference (McNemar’s test p = 0.388). Regarding the cellularity of the specimen, both in cytology and the cell block samples, no significant difference was observed between the techniques (p = 0.84 and 0.61, respectively). With respect to contaminating blood in the specimen, there was no difference in cytology samples (p = 0.89) and no difference in cell block samples (p = 0.08). The suitability of cytology samples for diagnosis was similar in both techniques (wet = 57.5% and capillary = 56.7%, p = 0.94) and there was no difference in cell block samples (wet = 75% and capillary = 66.1%, p = 0.38). In this study we did not observe differences in diagnostic yield or sample quality. Since both techniques are effective, we suggest the simultaneous and alternate use of both methods.

scholarly journals “COMPARATIVE STUDY OF FNAC, USG, US-FNAC, AND HPE IN DIAGNOSIS OF NECK SWELLINGS”

2021 ◽  
Vol Volume 9 (upjohns/volume9/Issue2) ◽  
pp. 15-21
Author(s):  
Sachin Jain
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Care Hospital ◽  
Neck Swelling ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

ABSTRACT Aims: This prospective study was carried out to compare findings of the four procedures namely FNAC (fine-needle aspiration cytology), USG (ultrasonography), US-FNAC (Ultrasound-guided fine-needle aspiration cytology), and HPE (histopathological examination). MATERIAL AND METHODS Total 80 cases of different neck swellings were selected from ENT OPD at tertiary care hospital Prayagraj Uttar Pradesh. All cases underwent the preoperative procedure of FNAC,USG, US-FNAC and postoperative HPE for diagnosing the neck swelling. The results of FNAC, USG, US-FNAC w e r e c o m p a r e d a n d c o r r e l a t e d w i t h histopathology findings and conclusions drawn after statistical analysis. RESULTS More than half (56.25%) of neck swellings were of thyroid swellings. It was observed that sensitivity, specificity, PPV, NPV, accuracy of FNAC of all neck swellings were 85.71%, 91.78% ,50%, 98.53% ,91.25% respectively. Sensitivity ,specificity, PPV ,NPV , accuracy of all neck swellings of USG were 71.43%, 98.63%, 83.33% , 97.26% 96.25 respectively. Sensitivity ,specificity, PPV ,NPV , accuracy of all neck swellings of US-FNAC were 85.71% ,97.26% ,75% , 98.61%, 96.25 respectively. CONCLUSION The combined use of USG and FNAC give more accuracy for proper diagnosis of neck swelling than FNAC alone. The most accurate diagnosis of

Evaluation of Pancreatic Lesions With Endoscopic Ultrasound and Fine Needle Aspiration

2020 ◽  
pp. 155335062092532
Author(s):  
Yan Luk ◽  
Wong Hoi She ◽  
Felix Che Lok Chow ◽  
Ka Wing Ma ◽  
Simon Hing Yin Tsang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
False Negative ◽  
Needle Aspiration ◽  
Pancreatic Lesion ◽  
Fine Needle ◽  
Histopathological Findings

Background. Endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) are commonly used for assessing pancreatic lesions. This study aimed to evaluate the diagnostic yield and accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in a single tertiary institution. Methods. Consecutive patients who underwent EUS-FNA of the pancreas at Queen Mary Hospital, Hong Kong, from January 2015 to March 2016 were retrospectively reviewed. Endoscopic findings and FNA results were analysed. For patients who subsequently underwent surgical resection of pancreatic lesion, EUS-FNA diagnoses were compared to histopathological findings of surgical specimens to determine its diagnostic accuracy. Results. One hundred twelve EUS-FNA were performed in 99 patients within the study time period and were included for analysis. Sixty-six (66.7%) pancreatic lesions were solid in nature and 33 (33.3%) were cystic. The overall diagnostic yield of EUS-FNA was 70.5% (n = 79). On multivariate analysis, more passes of needle were associated with a higher diagnostic yield (odds ratio = 2.000, P = .049). 57.1% (n = 64) of EUS-FNA results had an impact on management. Sixteen patients with diagnostic EUS-FNA subsequently underwent surgery for resection of the pancreatic lesion. Upon correlation to the histopathological findings of surgical specimens, there were 12 true-positive, 2 true-negative, 0 false-positive, and 2 false-negative cases. Sensitivity was 85.7%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 50%. The diagnostic accuracy of EUS-FNA was 87.5%. Conclusion. EUS-FNA is accurate and reliable for diagnosing pancreatic lesions.

Breast Fine Needle Aspiration Biopsy Cytology Using the Newly Proposed IAC Yokohama System for Reporting Breast Cytopathology: The Experience of a Single Institution

2019 ◽  
Vol 63 (4) ◽  
pp. 274-279 ◽  
Author(s):  
Diana Montezuma ◽  
Daniela Malheiros ◽  
Fernando C. Schmitt
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Reporting System ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Needle Aspiration Biopsy ◽  
Sensitivity Specificity

Objective: Recently the International Academy of Cytology (IAC) proposed a new reporting system for breast fine needle aspiration biopsy (FNAB) cytology. We aimed to categorize our samples according to this classification and to assess the risk of malignancy (ROM) for each category as well as the diagnostic yield of breast FNAB. Study Design: Breast FNAB specimens obtained between January 2007 and December 2017 were reclassified according to the newly proposed IAC Yokohama reporting system. The ROM for each category was determined. Diagnostic yield was evaluated based on a three-category approach, benign versus malignant. Results: The samples were distributed as follows: insufficient material 5.77%, benign 73.38%, atypical 13.74%, suspicious for malignancy 1.57%, and malignant 5.54%. Of the 3,625 cases collected, 776 (21.4%) had corresponding histology. The respective ROM for each category was 4.8% for category 1 (insufficient material), 1.4% for category 2 (benign), 13% for category 3 (atypical), 97.1% for category 4 (suspicious for malignancy), and 100% for category 5 (malignant). When only malignant cases were considered positive tests, the sensitivity, specificity, and diagnostic accuracy were 97.56, 100, and 99.11%, respectively. Conclusions: Our study is the first to categorize breast FNAB cytology samples according to the proposed IAC reporting system and to evaluate patient outcomes based on this categorization.

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