Feasibility and performance of the Idylla™ NRAS / BRAF cartridge mutation assay on thyroid liquid‐based fine‐needle aspiration

Abstract Context.—The cytologic features of adenocarcinoma/ metastatic carcinoma in liver fine-needle aspirates are well described. We review the cytologic findings from 16 aspirates of adenocarcinoma/metastatic carcinoma that were frequently misclassified as hepatocellular carcinomas and compare them with 17 cases that were rarely misclassified. Objective.—To compare the cytologic features of adenocarcinoma/metastatic carcinoma in fine-needle aspiration specimens of the liver that were frequently misclassified as hepatocellular carcinoma with those of aspirates that were rarely misclassified. Design.—We reviewed a total of 1712 interpretations from 33 different cases of adenocarcinoma/metastatic carcinoma tumor in liver fine-needle aspiration specimens in the College of American Pathologists Nongynecologic Cytology Program and correlated the cytologic features with performance in the program. Results.—Overall, cases that were frequently misclassified as hepatocellular carcinoma were misclassified on average 26% of the time (range, 13%–54%), while infrequently misclassified cases were interpreted as hepatocellular carcinoma on average 0.7% of the time (range, 0%– 3%). The difference was statistically significant (P < .001). On review, cases that were frequently misclassified most often had moderate amounts of granular cytoplasm (16/16 cases) and round nuclei with even chromatin (13/16 cases). Trabeculae (3/16 cases), bare nuclei (2/16 cases), and endothelial wrapping (1/16 cases) were also occasionally present. In contrast, cases that were rarely misclassified were more likely to have areas with cells showing scant cytoplasm that were crowded and overlapped or molded (13/17 cases) and contained dark hyperchromatic chromatin (13/17 cases) compared to cases that were frequently misclassified (P < .001 and P = .002, respectively). Trabeculae (2/17) and bare nuclei (2/17 cases) were also rarely present. Conclusion.—Cases of adenocarcinoma/metastatic carcinoma with moderate amounts of granular cytoplasm and round nuclei with even chromatin are frequently misclassified as hepatocellular carcinoma. Recognition of this problem, attention to cytologic criteria, and frequent use of immunohistochemical studies and core biopsy may help avoid this pitfall.

Download Full-text

Thyroid fine needle aspiration: How to improve clinicians’ confidence and performance with the technique

Cancer Letters ◽

10.1016/j.canlet.2008.02.056 ◽

2008 ◽

Vol 264 (2) ◽

pp. 163-171 ◽

Cited By ~ 17

Author(s):

A. Carpi ◽

G. Di Coscio ◽

G. Iervasi ◽

A. Antonelli ◽

J. Mechanick ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Needle Aspiration ◽

Fine Needle ◽

Thyroid Fine Needle Aspiration ◽

And Performance

Download Full-text

Distinguishing Carcinoid Tumor of the Mediastinum From Thymoma: Correlating Cytologic Features and Performance in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology

Archives of Pathology & Laboratory Medicine ◽

10.5858/2006-130-1612-dctotm ◽

2006 ◽

Vol 130 (11) ◽

pp. 1612-1615

Author(s):

Andrew A. Renshaw ◽

Jennifer C. Haja ◽

Margaret H. Neal ◽

David C. Wilbur

Keyword(s):

Carcinoid Tumor ◽

Fine Needle Aspiration ◽

Interlaboratory Comparison ◽

Correct Diagnosis ◽

Needle Aspiration ◽

Fine Needle ◽

And Performance ◽

Salt And Pepper

Abstract Context.—The cytologic features of carcinoid tumor in mediastinal fine-needle aspiration are well described. Nevertheless, this tumor may be difficult to distinguish from thymoma in this site. Objective.—We sought to correlate the cytologic features of carcinoid tumor of the mediastinum in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology with the frequency of misclassification as thymoma. Design.—We reviewed 446 interpretations from 18 different cases of carcinoid tumor in mediastinum and correlated the cytologic features with performance. Results.—Cases were more frequently classified as thymoma (158 responses, 35%) than as carcinoid tumor (126 responses, 28%). The best-performing case was classified as carcinoid tumor only 56% of the time. Three cytologic patterns were identified. Four cases consisted of isolated round cells with salt-and-pepper chromatin. Four cases consisted of isolated spindle and round cells with salt-and-pepper chromatin. The remaining 10 cases consisted of cohesive fragments of crowded cells with finely granular chromatin showing numerous pyknotic cells mimicking lymphocytes. Prominent vasculature patterns were not a feature of any of the cases. There was no correlation between any pattern and the rate of classification as carcinoid tumor or thymoma (P > .05). Conclusions.—Carcinoid tumor of the mediastinum is frequently misclassified as thymoma in this program. Although some cytologic patterns resemble thymoma, the lack of correlation of these patterns with performance suggests that at least part of the reason for misclassification may be failure to consider the correct diagnosis or a lack of familiarity with discriminating cytologic criteria.

Download Full-text

Endoscopic Ultrasound–guided Fine-Needle Aspiration Biopsy Coupled With a KRAS Mutation Assay Using Allelic Discrimination Improves the Diagnosis of Pancreatic Cancer

Journal of Clinical Gastroenterology ◽

10.1097/mcg.0000000000000053 ◽

2015 ◽

Vol 49 (1) ◽

pp. 50-56 ◽

Cited By ~ 34

Author(s):

Barbara Bournet ◽

Janick Selves ◽

David Grand ◽

Marie Danjoux ◽

Naima Hanoun ◽

...

Keyword(s):

Pancreatic Cancer ◽

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Kras Mutation ◽

Fine Needle Aspiration Biopsy ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Allelic Discrimination ◽

Fine Needle ◽

Mutation Assay

Download Full-text

Outcomes and Performance Characteristics of Small Thyroid Lesions Sampled by Fine Needle Aspiration Biopsy

Journal of the American Society of Cytopathology ◽

10.1016/j.jasc.2015.09.195 ◽

2015 ◽

Vol 4 (6) ◽

pp. S81

Author(s):

Scott Bibbey ◽

Yumei Fu ◽

Brian Collins

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Biopsy ◽

Needle Aspiration ◽

Performance Characteristics ◽

Aspiration Biopsy ◽

Fine Needle ◽

Needle Aspiration Biopsy ◽

And Performance ◽

Thyroid Lesions

Download Full-text

Distinguishing Small Cell Carcinoma From Non–Small Cell Carcinoma of the Lung: Correlating Cytologic Features and Performance in the College of American Pathologists Non-Gynecologic Cytology Program

Archives of Pathology & Laboratory Medicine ◽

10.5858/2005-129-0619-dsccfn ◽

2005 ◽

Vol 129 (5) ◽

pp. 619-623 ◽

Cited By ~ 4

Author(s):

Andrew A. Renshaw ◽

Theresa M. Voytek ◽

Jennifer Haja ◽

David C. Wilbur

Keyword(s):

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Fine Needle Aspiration ◽

Clinical Importance ◽

Needle Aspiration ◽

Small Cell ◽

Fine Needle ◽

Intracytoplasmic Lumina ◽

And Performance

Abstract Context.—The cytologic features of small cell carcinoma of the lung are well described. Nevertheless, some small cell carcinomas may be difficult to reproducibly distinguish from non–small cell carcinomas, and this distinction carries significant clinical importance. Objective.—To correlate the cytologic features of individual cases of small cell carcinoma of the lung in fine-needle aspiration specimens from the College of American Pathologists Non-Gynecologic Peer Comparison Cytology Program with the frequency of misclassification as non– small cell carcinoma. Design.—We reviewed 1185 interpretations of 23 different cases of small cell carcinoma in lung fine-needle aspiration specimens and correlated the cytologic features noted in these cases with performance in the program. Results.—Cases were divided into those that were frequently misclassified as non–small cell carcinoma (at least 10% of the responses, 11 cases) and those that were infrequently misclassified as non–small cell carcinoma (<5% of all responses, 12 cases). All cases had areas on the slides with classic features of small cell carcinoma. However, 10 of 11 cases that were frequently misclassified as non–small cell carcinoma had cells with either increased cytoplasm (4 cases), cytoplasmic globules (so-called paranuclear blue bodies) (3 cases), or apparent intracytoplasmic lumina (3 cases). These features were not identified in cases that were infrequently misclassified (P = .005). In addition, cases more frequently misclassified as non–small cell carcinoma tended to show better overall cellular and group preservation. Conclusions.—Frequent misclassification of small cell carcinoma as non–small cell carcinoma in lung fine-needle aspiration specimens in this program correlates strongly with the presence of cytoplasmic features that may suggest non–small cell carcinoma or with the presence of paranuclear blue bodies. Misclassification in this program may reflect a variety of factors, including the variation in the cytologic features of individual cases, but also the lack of wide recognition that some features of non–small cell carcinoma may also be noted in well-preserved cases of small cell carcinoma.

Download Full-text