Parotid Tumors: Fine-Needle Aspiration and/or Frozen Section

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P42-P43
Author(s):  
Peter Zbaren ◽  
Heinz Loosli ◽  
Edouard Stauffer
Keyword(s):  
Sensitivity And Specificity ◽  
Fine Needle Aspiration ◽  
False Positive ◽  
Frozen Section ◽  
False Negative ◽  
Needle Aspiration ◽  
True Positive ◽  
True Negative ◽  
Fine Needle ◽  
Parotid Neoplasms

Objective Assess the difficulties of preoperative and intraoperative tumor typing of parotid neoplasms. Know the advantages and pitfalls of fine-needle-aspiration cytology (FNAC) and frozen section (FS) analysis in primary parotid neoplasms. Methods In 113 parotid neoplasms (70 malignancies and 43 benign tumors) preoperative FNAC as well as intraoperative FS analysis were performed. FNAC and FS findings were analyzed and compared with the final histopathologic diagnosis. Results The FNAC smear was non-diagnostic in 6 tumors. In 2 FS specimens, it was not possible to determine the tumor dignity. FNAC findings and FS findings were both available in 105 neoplasMS The FNAC findings were true positive for malignancy in 54, true negative in 36, false positive in 4, and false negative in 11 tumors. The accuracy, sensitivity, and specificity were 86%, 83%, and 90% respectively. The FS findings were true positive in 60, true negative in 38, false positive in 2, and false negative in 5 tumors. The accuracy, sensitivity, and specificity were 93%, 92% and 95% respectively. The exact histologic tumor typing by FNAC was correct, false or not mentioned in 58%, 20% and 22% true positive or true negative evaluated tumors, and by FS in 83%, 5% and 12% true positive or true negative evaluated tumors. Conclusions The current analysis showed a superiority of FS compared with FNAC regarding the diagnosis of malignancy and especially of tumor typing. FNAC alone is not prone in many cases to determine the surgical management of primary parotid carcinomas.

scholarly journals Discordance between fine-needle aspiration cytology and histopathology in patients with mucoepidermoid carcinoma of parotid gland

2020 ◽  
Vol 102 (5) ◽  
pp. 340-342
Author(s):  
H Iftikhar ◽  
M Sohail Awan ◽  
M Usman ◽  
A Khoja ◽  
W Khan
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Mucoepidermoid Carcinoma ◽  
False Negative ◽  
Needle Aspiration ◽  
True Positive ◽  
Aspiration Cytology ◽  
True Negative ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Introduction Fine-needle aspiration cytology (FNAC) is an important diagnostic tool used preoperatively for the diagnosis of parotid lump. Mucoepidermoid carcinoma comprises 5–10% of all salivary gland tumours. It poses a diagnostic challenge on FNAC with high false negative rate. The objective of this study was to evaluate the discordance between cytology/FNAC and histopathology in patients with mucoepidermoid carcinoma. Material and methods A cross-sectional study was conducted from 1 January 2010 to 31 December 2014. Patients aged 18 years and above with FNAC or histopathology suggestive of mucoepidermoid carcinoma were identified. FNAC when compared with histology (gold standard) was classified into true positive (presence of mucoepidermoid carcinoma correctly diagnosed on FNAC), true negative (absence of mucoepidermoid carcinoma correctly diagnosed on FNAC), false positive (FNAC incorrectly diagnosed mucoepidermoid carcinoma), false negative (FNAC failed to diagnose mucoepidermoid carcinoma). Results A total of 16 patients fulfilled our eligibility criteria. Seven cytological samples were true positive (ie correctly diagnosed mucoepidermoid carcinoma by FNAC), eight cytological specimens were false negative (ie could not pick up mucoepidermoid carcinoma on FNAC). One case was false positive on cytology (ie diagnosed mucoepidermoid carcinoma on FNAC but was reported to be Warthin’s tumour on histopathology) and none were true negative. Conclusion FNAC is not reliable for diagnosis of mucoepidermoid carcinoma. More than 50% of our patients had discordant results between cytology and histology. We recommend a high index of suspicion for mucoepidermoid carcinoma given the poor yield of cytology.

Pitfalls in Salivary Gland Fine-Needle Aspiration Cytology: Lessons From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology

2005 ◽  
Vol 129 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Jonathan H. Hughes ◽  
Emily E. Volk ◽  
David C. Wilbur
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
False Positive ◽  
Interlaboratory Comparison ◽  
False Negative ◽  
Diagnostic Errors ◽  
Poor Performance ◽  
Needle Aspiration ◽  
Low Grade ◽  
Fine Needle

Abstract Context.—We use data from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology to identify common diagnostic errors in salivary gland fine-needle aspiration (FNA). Objective.—To identify salivary gland FNA cases with poor performance characteristics in the Nongynecologic Cytology Program surveys, so that the most common diagnostic pitfalls can be avoided. Design.—A retrospective review of the College of American Pathologists Nongynecologic Cytology Program's cumulative data from 1999 to 2003 revealed the most common false-positive and false-negative interpretations on FNA for common salivary gland lesions. Slides that performed poorly were then reviewed to identify the cytologic characteristics that may have contributed to their poor performance. Results.—A total of 6249 participant responses with general interpretations of benign (n = 4642) or malignant (n= 1607) were reviewed. The sensitivity and specificity of the participant responses for correctly interpreting the cases as benign or malignant were 73% and 91%, respectively. Benign cases with the highest false-positive rates were monomorphic adenoma (53% false-positive), intraparotid lymph node (36%), oncocytoma (18%), and granulomatous sialadenitis (10%). Malignant cases with the highest false-negative rates were lymphoma (57%), acinic cell carcinoma (49%), low-grade mucoepidermoid carcinoma (43%), and adenoid cystic carcinoma (33%). Selected review of the most discordant individual cases revealed possible explanations for some of the interpretative errors. Conclusions.—These data confirm the difficulty associated with interpretation of salivary gland FNA specimens. Cytologists should be aware of the potential false-positive and false-negative interpretations that can occur in FNAs from this organ site in order to minimize the possibility of diagnostic errors.

False-positive and false-negative cases of fine-needle aspiration cytology for palpable breast lesions

Breast Cancer ◽  
2007 ◽  
Vol 14 (4) ◽  
pp. 388-392 ◽  
Author(s):  
Takashi Ishikawa ◽  
Yohei Hamaguchi ◽  
Mikiko Tanabe ◽  
Nobuyoshi Momiyama ◽  
Takashi Chishima ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
False Positive ◽  
Fine Needle Aspiration Cytology ◽  
False Negative ◽  
Needle Aspiration ◽  
Breast Lesions ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Palpable Breast ◽  
Needle Aspiration Cytology

Accuracy of Fine-Needle Aspiration of Thyroid

2001 ◽  
Vol 125 (4) ◽  
pp. 484-488 ◽  
Author(s):  
Mojghan Amrikachi ◽  
Ibrahim Ramzy ◽  
Sheldon Rubenfeld ◽  
Thomas M. Wheeler
Keyword(s):  
Fine Needle Aspiration ◽  
False Positive ◽  
Thyroid Nodules ◽  
False Negative ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Follicular Variant ◽  
Fine Needle

Abstract Context.—Fine-needle aspiration has become an accepted and cost-effective procedure for rapid diagnosis of thyroid lesions. The routine use of fine-needle aspiration has reduced the rate of unnecessary surgery for thyroid nodules. Objectives.—To determine the accuracy of fine-needle aspiration biopsy diagnosis and to discuss the possible pitfalls. Design, Setting, and Participants.—Reports of 6226 fine-needle aspiration biopsies of the thyroid performed during a period of 16 years (1982–1998) were reviewed. Computerized reports of the fine-needle aspiration biopsies were sent to the physicians who performed the procedures, and clinical follow-up information regarding the patients was requested. Twenty-four clinicians participated in the study. Histologic diagnoses were available for 354 cases. The cytopathologic diagnoses were correlated with the histologic findings or clinical outcomes. Results.—The cytologic diagnoses were as follows: 210 (3.4%) malignant, 450 (7.2%) suspicious, 3731 (60%) benign, and 1845 (29.5%) unsatisfactory. Most of the cases with negative or unsatisfactory aspirates were followed clinically or by repeat fine-needle aspiration. We identified 11 false-negative and 7 false-positive diagnoses. For aspirates considered sufficient for diagnosis, the sensitivity and specificity levels were 93% and 96%, respectively. Conclusions.—Fine-needle aspiration of the thyroid gland is highly accurate and has a low rate of false-negative and false-positive diagnoses. The major diagnostic problems are caused by diagnosis using a marginally adequate specimen, diagnosis of malignancy based on just 1 or 2 atypical cytologic features, or overlapping cytologic features of follicular neoplasm with those of follicular variant of papillary carcinoma.

scholarly journals Correlation of fine needle aspiration cytology and histopathological examination in thyroid swellings: a prospective study

2019 ◽  
Vol 5 (3) ◽  
pp. 718
Author(s):  
Shenbagavalli S. ◽  
Muthukumar R.
Keyword(s):  
Physical Examination ◽  
Fine Needle Aspiration ◽  
False Positive ◽  
Histopathological Examination ◽  
False Negative ◽  
Needle Aspiration ◽  
Thyroid Function Tests ◽  
Benign Lesions ◽  
Fine Needle ◽  
Positive Results

<p class="abstract"><strong>Background:</strong> Thyroid swellings are not an uncommon condition. Physical examination, laboratory investigation, thyroid imaging, and cytology can be used to evaluate thyroid swellings. After a physical examination, ultrasonography and thyroid function tests, fine needle aspiration (FNA) cytology should be implemented. Although FNA cytology is a common method to evaluate the nodule, false negative and false positive results are not rare. Hence histopathology examination is confirmatory. Information gathered from history, physical examination, ultrasound and intraoperative appearance of thyroid swelling dictate further management. The purpose of the study is to correlate preoperative FNAC and postoperative histopathology in thyroid swellings.</p><p class="abstract"><strong>Methods:</strong> This study of 52 in-patients with thyroid lesions was treated at UIORL-RGGGH MMC Chennai. FNAC and USG were used as preoperative tools for determining the procedure to be performed and was followed by HPE postoperatively for further<strong> </strong>management.  </p><p class="abstract"><strong>Results:</strong> Diagnostic categorization of 52 thyroid swellings were based on FNAC and histopathology. According to FNAC, 88.46% swellings were benign lesions and 11.54% were a malignancy. According to HPE, 82.69% were benign lesions and 17.31% were a malignancy. In our study, the collection of thyroid cases emphasizes the false negativity of FNAC. Cases suspicious of malignancy were decided based on intraoperative changes and were given a note of caution to the pathologists for a meticulous evaluation of slides.</p><p class="abstract"><strong>Conclusions:</strong> FNAC is a simple, safe and cost-effective modality of investigation for thyroid disease but in cases of false negativity histopathology is confirmatory. The false positive results were found to be nil however there is a low percentage of false negative results which has to be confirmed by HPE.</p>

Parotid Tumors: Fine-Needle Aspiration and/or Frozen Section

2008 ◽  
Vol 139 (6) ◽  
pp. 811-815 ◽  
Author(s):  
Peter Zbären ◽  
Dominique Guélat ◽  
Heinz Loosli ◽  
Edouard Stauffer
Keyword(s):  
Sensitivity And Specificity ◽  
Fine Needle Aspiration ◽  
Malignant Tumors ◽  
Frozen Section ◽  
Needle Aspiration ◽  
Benign Tumors ◽  
Malignant Neoplasms ◽  
Tumor Type ◽  
Fine Needle ◽  
Parotid Tumors

Objective The purpose of this study was to analyze and compare the value of fine-needle aspiration cytology (FNAC) and frozen section (FS) analysis in the assessment of parotid gland tumors. Study Design Chart review and cross-sectional analysis. Subjects and Methods FNAC and FS analysis of 110 parotid tumors, 68 malignancies and 42 benign tumors, were analyzed and compared with the final histopathologic diagnosis. Results The accuracy, sensitivity, and specificity of FNAC in detecting malignant tumors were 79 percent, 74 percent, and 88 percent, respectively. On FS analysis, the accuracy, sensitivity, and specificity in detecting malignant tumors were 94 percent, 93 percent, and 95 percent, respectively. The histologic tumor type was correctly diagnosed by FNAC and FS in 27 of 42 (64%) and 39 of 42 (93%) benign tumors, respectively, and in 24 of 68 (35%) and 49 of 68 (72%) malignant neoplasms, respectively. Conclusion The current analysis showed a superiority of FS compared with FNAC regarding the diagnosis of malignancy and tumor typing. FNAC alone is not prone to determine the surgical management of parotid malignancies.

On Cytologic Vagaries in the Diagnosis of Breast Tumors

1980 ◽  
Vol 66 (2) ◽  
pp. 191-196 ◽  
Author(s):  
Tadeusz Biedrzycki ◽  
Maria Dabska ◽  
Ludwika Sikorowa ◽  
Tadeusz Kubicki
Keyword(s):  
Fine Needle Aspiration ◽  
False Positive ◽  
Fine Needle Aspiration Biopsy ◽  
False Negative ◽  
Breast Tumors ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Biopsy Technique ◽  
Positive Results

The article describes the difficulties, the errors and limitations of the fine needle aspiration biopsy technique in the diagnosis of the breast tumors encountered during a 2.5 year period of activity. The question of false-negative and false-positive results and the way these problems were partly overcome in the Institute of Oncology in Warsaw are discussed in detail.

Parotidectomy: A Ten Year Experience with Fine Needle Aspiration and Frozen Section Biopsy Correlation

1994 ◽  
Vol 73 (6) ◽  
pp. 377-380 ◽  
Author(s):  
Cliff A. Megerian ◽  
Anthony J. Maniglia
Keyword(s):  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Frozen Section ◽  
Diagnostic Testing ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Accuracy Rate ◽  
Fine Needle ◽  
Negative Rate

During the years 1980 through 1990, 247 patients underwent parotidectomy at our institution for the removal of primary parotid lesions. Charts were reviewed in an effort to document the distribution of pathology in patients undergoing parotidectomy and the histopathology from each case was organized and tallied by virtue of the final specific diagnoses. An additional goal of this study was to evaluate the efficacy of pre-operative fine-needle aspiration biopsy (FNAB) and frozen section pathology in accurately predicting final histopathology. In our series, 86.7% of lesions were found to be benign and 13.3% were malignant in nature. When compared to final pathologic findings, FNAB yielded a diagnostic accuracy rate of 89.3% with a 2.1% false negative rate with regards to pre-operative detection of malignancy. Frozen section biopsy was found to have a diagnostic accuracy of 94.1% and also demonstrated a 2.1% false-negative rate. We believe these studies are indeed complementary to each other, as reflected in the 96.2% diagnostic accuracy achieved with a combination of FNAB and frozen section biopsy information. This report will review the patterns of misdiagnosis for each modality of diagnostic testing and present the parotid histopathology found over a 10-year period.

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