ANALYSIS OF FALSE POSITIVE AND FALSE NEGATIVE FINE NEEDLE ‎ASPIRATION CYTOLOGY OF BREAST LUMP : A PERSONAL ‎EXPERIENCE

Objective: To evaluate the role of Fine Needle Aspiration Cytology in the preoperative diagnosis of malignancy in parotid and submandibular gland neoplasm. Methods: This cross sectional study on 50 cases was conducted in the Department of Otolaryngology and Head-Neck Surgery of Sir Salimullah Medical College Mitford Hospital and Dhaka Medical College Hospital from January2009 to June 2010. Results: Fine needle aspiration cytology findings of our all 50 cases were compared with postoperative histopathological reports. Out of the 50 cases, in 36(72%) cases of benign neoplasm and 7(14%) cases of malignant neoplasm, pre-operative FNAC findings and post operative histopathological findings were same. In 7 cases, FNAC and post operative histopathological findings did not matched. These were 2 (4%) false positive and 5 (10%) false negative result.In our study sensitivity of FNAC for reporting malignancy was 58.33%, specificity to rule out malignancy was 94.73% and overall accuracy in detecting malignant tumour was 86%. Positive predictive value and negative value were 77.77% and 87.80% respectively. It can be concluded that fine needle aspiration cytology is a safe, cheap and useful preoperative diagnostic tool in the diagnosis of malignancy in parotid and submandibular gland, but as fine needle aspiration cytology partly depends on operator skill, it may give false negative and false positive result. Conclusion: FNAC is a useful preoperative diagnostic tool for malignant parotid and submandibular glands with high specificity and sensitivity. DOI: http://dx.doi.org/10.3329/bjo.v19i2.17634 Bangladesh J Otorhinolaryngol 2013; 19(2): 110-118

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Fibroadenoma Mimicking Papillary Carcinoma on ThinPrep of Fine-Needle Aspiration of the Breast

Archives of Pathology & Laboratory Medicine ◽

10.5858/2000-124-1667-fmpcot ◽

2000 ◽

Vol 124 (11) ◽

pp. 1667-1669

Author(s):

Timothy Myers ◽

Helen H. Wang

Keyword(s):

Fine Needle Aspiration ◽

Stromal Cells ◽

Fine Needle Aspiration Cytology ◽

Smooth Muscle Actin ◽

Single Cells ◽

False Negative ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology

Abstract Objective.—To compare and contrast benign and malignant lesions of the breast that have similar appearances on fine-needle aspiration cytology and that constitute diagnostic pitfalls. Design.—The cytology files (dated November 1995 through May 1998) of the Beth Israel Deaconess Medical Center were searched to identify cases of breast fine-needle aspiration biopsies that were highly cellular and composed of bland-appearing spindle/columnar cells and that could represent either epithelial or stromal cells; these cases were reported as indeterminate (atypical/suspicious) and had subsequent excisional biopsies taken. Results.—Four such cases were found. Two were fibroadenomas and 2 were papillary carcinomas. Their appearances were strikingly similar on aspiration cytology. All cases were prepared with the ThinPrep method. On microscopic examination, all 4 cases were hypercellular and had many single cells and clusters of columnar/elongate cells. Immunocytochemistry proved these cells to be of epithelial origin. At least occasional bipolar stromal cells were seen in the background. The only appreciable difference between the benign and malignant cases was more significant nuclear atypia, which was barely discernible, in the malignant cases. Immunocytochemistry for smooth muscle actin was helpful in 2 cases that had sufficient material. Conclusions.—Some cases of fibroadenomas and papillary carcinomas can be very difficult, if not impossible, to distinguish on fine-needle aspiration cytology. Immunocytochemistry may be helpful if sufficient material is available. To avoid false-negative or false-positive diagnosis on cytology, it is best to report such cases as atypical or suspicious with final diagnosis pending excisional biopsy.

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Microfilaria in fine needle aspiration cytology of breast lump: An unusual finding

Journal of Health Specialties ◽

10.4103/1658-600x.166491 ◽

2015 ◽

Vol 3 (4) ◽

pp. 235 ◽

Cited By ~ 3

Author(s):

Subrata Pal ◽

Kingshuk Bose

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Needle Aspiration ◽

Breast Lump ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology ◽

Unusual Finding

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Diagnostic Accuracy of Fine Needle Aspiration Cytology of Thyroid Pathologies

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v19i2.27329 ◽

2020 ◽

Vol 19 (2) ◽

pp. 84-89

Author(s):

Shova Kunwar ◽

Barsha Bajracharya ◽

Kavita Karmacharya ◽

Amar Narayan Shrestha

Keyword(s):

Fine Needle Aspiration ◽

Predictive Value ◽

Fine Needle Aspiration Cytology ◽

False Negative ◽

False Negative Rate ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Thyroid Lesion ◽

Fine Needle ◽

Needle Aspiration Cytology

Introduction: Fine needle aspiration cytology is considered as the gold standard for the diagnosis of thyroid nodules. This study aimed to evaluate and compare the accuracy of fine-needle aspiration cytology in the diagnosis of thyroid lesion by comparing it with the corresponding histopathologic diagnosis after thyroidectomy. Methods: This is a retrospective study conducted over five years at a teaching hospital in Kathmandu. Eighty-nine cases of FNAC of thyroid nodule with subsequent histopathological reports were reviewed. The corresponding reports were compared and the accuracy of FNAC diagnosis was evaluated. Results: 87% of the cases were females and the majority of cases were in the age group 41 to 50 years. Among 89 cases, 55 were reported as benign on cytology and 34 were reported as malignant. On histopathological examination, out of 55 cases diagnosed as benign on cytology, 47 cases were diagnosed as benign whereas eight cases were diagnosed as malignant. HPE of 34 cases diagnosed as malignant on cytology showed that 29 were malignant and five were benign. The false-positive rate was 9.6% and the false-negative rate was 21.6%. The sensitivity was 78.3% and specificity was 90.3%. The positive predictive value and negative predictive value were 85.2% and 85.4% respectively. The accuracy of FNAC in differentiating benign from malignant thyroid lesions was 85.3%. Conclusions: The findings of this study showed that FNAC is a sensitive method for the diagnosis of a solid thyroid lesion

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

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2020.0022 ◽

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.

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Fine needle aspiration cytology of salivary gland lesions reported immediately in a head and neck clinic

The Journal of Laryngology & Otology ◽

10.1017/s0022215100125162 ◽

1993 ◽

Vol 107 (11) ◽

pp. 1025-1028 ◽

Cited By ~ 41

Author(s):

N. J. Roland ◽

A. W. Caslin ◽

P. A. Smith ◽

L. S. Turnbull ◽

A. Panarese ◽

...

Keyword(s):

Salivary Gland ◽

Head And Neck ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

False Negative ◽

Neck Surgery ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology

AbstractThis paper describes the application of fine needle aspiration cytology (FNAC) performed on92 patients with salivary gland lesions in a Head and Neck Surgery Clinic. The aspirates were immediately reported by a cytopathologist and the reports conveyed to the surgeon during the same clinic visit. FNAC results were then compared with histology in those patients who underwent surgery and with the clinical course of the disease at subsequent clinic visits in patients where surgery was not performed. The cytological diagnosis was incorrect in five cases, one of which was a false negative result. There were no false positive results. The sensitivity was 90.9 per cent and the specificity 100 per cent. This rapid report system of fine needle aspiration cytology has been found to be safe, free of complications, and helpful in the planning of treatment.

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Significance of Quadruple assessment of breast lump–A hospital based study

Journal of Pathology of Nepal ◽

10.3126/jpn.v4i8.11499 ◽

2014 ◽

Vol 4 (8) ◽

pp. 630-634

Author(s):

MK Shrestha ◽

D Ghartimagar ◽

A Ghosh ◽

E Shrestha ◽

P Bolar

Keyword(s):

Breast Cancer ◽

Sensitivity And Specificity ◽

Fine Needle Aspiration ◽

Gold Standard ◽

Fine Needle Aspiration Cytology ◽

Needle Aspiration ◽

Breast Lump ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology

Background: Approximately 10% of breast masses are breast cancer. It is important for women with a breast lump to receive appropriate evaluation. Mammography has been the “gold standard” in breast cancer detection for >40 years. Ultrasonography is non-invasive easily available, cheaper and accurate tool while Fine needle aspiration cytology has a high diagnostic accuracy rate in hands of experienced cytopathologist. Materials and methods: This was a retrospective and prospective study of 173 women attending radiology department in Manipal Teaching Hospital, Pokhara for mammography during a period of 18 months from January 2011 to June 2012.The age ranged from 20yrs to 75yrs. BIRADS score was given for both mammography and sonomammography. All malignant and suspicious cases had undergone fine needle aspiration cytology. Cytology reports were correlated with imaging study. Results: The most common age group for the breast lump was 40-49 years showing 65(37.57%) cases. Most lumps were seen on the left side 54.3% (94/ 173) cases and were seen in upper outer quadrant of the breast (74 cases). 11 cases each were given the BIRADS score of 4 in both mammography and sonomammography. Sensitivity and specificity of mammography and sonomammography were compared to cytologyreports. The sensitivity for mammogram was 73.7% while specificity was 96.3%. The sensitivity and specificity for sonomammogram was 78.9% and 95% respectively. Conclusion: Quadruple assessment i.e. clinical assessment, mammography, sonomammography and cytological study are the new “gold standard” in the investigation of breast disease. DOI: http://dx.doi.org/10.3126/jpn.v4i8.11499 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 630-634

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Fine Needle Aspiration Cytology of Palpable Breast Lumps - Their Cytological Spectrum and Histopathological Correlation

KYAMC Journal ◽

10.3329/kyamcj.v7i2.33838 ◽

2017 ◽

Vol 7 (2) ◽

pp. 780-786

Author(s):

Shaheen Akter ◽

Md Jahidul Islam ◽

Md Shariful Haque

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Needle Aspiration ◽

Breast Lump ◽

Aspiration Cytology ◽

Fine Needle ◽

Histopathological Correlation ◽

Palpable Breast ◽

Needle Aspiration Cytology ◽

Breast Lumps

Background: With the advent of fine needle aspiration cytology (FNAC), the approach to diagnosis and management of breast lumps has been revolutionized and it has high sensitivity and specificity.Aim: In this study we analyze the spectrum of FNAC diagnoses in breast lumps and compare the diagnostic accuracy of fine FNAC in differentiating the benign and malignant lesions of breast lumps with histopathological correlation.Materials & Methods: Two years prospective study was conducted in our institution and in that 490 aspirations, including 6 bilateral were performed. Suppurative and inflammatory lesions were excluded from the total aspirates. The cytological diagnosis was classified into 3 groups benign, suspicious and malignant. After this reporting all the available 94 cases were later subjected to mastectomy or open/excision biopsy and followed-up by histopathological confirmation. Later diagnostic accuracy of cytology reporting was compared with that of histopathology.Results: A total of 490 FNAC cases were reported including 373 as benign, 4 as suspicious for carcinoma and 113 as carcinoma. Majorities were premenopausal females and commonest age group was 31-40 years. Among them only 94 cases were followed-up by histopathologic confirmation. In histopathological correlation study, we had accuracy rate of 100% for benign lesion and 92.10% for malignant lesion with false negative rate of 7.90% and false positive rate of zero with fine needle aspiration cytology in the diagnosis of palpable breast lump. The overall sensitivity of fine needle aspiration in diagnosing the palpable breast lump is 92.10%, specificity is 100%, positive predictive value is 100% and negative predictive value is 94.91%.Conclusion: FNAC in experienced hands is a very useful tool with very high specificity and rare false positive result. Sensitivity can be further improved with clinical and imaging correlation.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 780-786

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