Fine-Needle Aspiration of Pulmonary Hamartoma: A Common Source of False-Positive Diagnoses in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology

2005 ◽  
Vol 129 (1) ◽  
pp. 19-22 ◽  
Author(s):  
Jonathan H. Hughes ◽  
Nancy A. Young ◽  
David C. Wilbur ◽  
Andrew A. Renshaw ◽  
Dina R. Mody
Keyword(s):  
Fine Needle Aspiration ◽  
False Positive ◽  
Interlaboratory Comparison ◽  
False Positive Rate ◽  
Diagnostic Errors ◽  
Needle Aspiration ◽  
Specific Reference ◽  
Common Source ◽  
Fine Needle ◽  
Pulmonary Hamartoma

Abstract Context.—We use data from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology to evaluate the accuracy of fine-needle aspiration (FNA) biopsy for diagnosing pulmonary hamartoma (PH). Objective.—To use the performance characteristics of the PH cases in the Nongynecologic Cytology Program to determine the accuracy of FNA for identifying these lesions and to determine potential sources of interpretative errors. Design.—A retrospective review of the College of American Pathologists Nongynecologic Cytology cumulative data from 1997 to 2003 was performed to identify the overall accuracy of FNA for diagnosing PH and to determine the most common interpretative pitfalls. The slides from each of the cases of PH in the Nongynecologic Cytology Program were then reviewed in an effort to identify the cytologic characteristics that contributed to the poor performance of these cases. Results.—A total of 766 participant responses for 19 PH FNA specimens were reviewed. The specificity of FNA for making the correct general reference interpretation of benign was 78%. The false-positive rate was 22%, with the most common false-positive diagnoses being carcinoid tumor, adenocarcinoma, and small cell carcinoma. The overall accuracy for making the correct specific reference diagnosis of PH was 26%. Microscopic review of the individual cases revealed possible explanations for some of the interpretative errors and the most frequent false-positive interpretations. Conclusions.—Cytologists should be aware of the potential false-positive interpretations that can occur in FNAs of PH and the potential reasons for these inaccuracies in order to minimize clinically significant diagnostic errors.

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 diagnosis in fine-needle aspiration of an atypical Warthin's tumor: Histochemical differential stains for cytodiagnosis

1989 ◽  
Vol 5 (4) ◽  
pp. 412-415 ◽  
Author(s):  
Rodolfo Laucirica ◽  
James B. Farnum ◽  
Sophie K. Leopold ◽  
George B. Kalin ◽  
George A. Youngberg
Keyword(s):  
Fine Needle Aspiration ◽  
False Positive ◽  
Needle Aspiration ◽  
Warthin’S Tumor ◽  
Fine Needle ◽  
Positive Diagnosis ◽  
False Positive Diagnosis ◽  
Warthin's Tumor

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

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.

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.

Fine Needle Aspiration Diagnosis of Tuberculous Lymphadenitis

2002 ◽  
Vol 32 (3) ◽  
pp. 147-149 ◽  
Author(s):  
Uma Handa ◽  
Anshu Palta ◽  
Harsh Mohan ◽  
R P S Punia
Keyword(s):  
Developing Countries ◽  
Fine Needle Aspiration ◽  
False Positive Rate ◽  
False Negative ◽  
Needle Aspiration ◽  
Acid Fast Bacillus ◽  
Tuberculous Lymphadenitis ◽  
Fine Needle ◽  
Lymph Node Tuberculosis ◽  
High Level

The diagnosis and management of peripheral lymph node tuberculosis remains a major problem in most of the developing countries. We retrieved 584 cases of tuberculous lymphadenitis from a total 1124 lymphnode aspirations done over a period of 3 years (1995–1998). Overall acid-fast bacillus positivity was 37.4%, being highest in the cases in which purulent material was aspirated. Fine needle aspiration (FNA) of tuberculous lymphadenopathy provided a high level of diagnostic accuracy as shown by 1.7% false negative and a zero false positive rate. FNA is reliable as an initial evaluating procedure for diagnosis of tuberculous lymphadenitis making it suitable for wider application in developing countries with scant resources.

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