Triage of Cytologic Direct Smears for Ancillary Studies: A Case-Based Illustration and Review

2013 ◽  
Vol 137 (9) ◽  
pp. 1185-1190 ◽  
Author(s):  
Michael H. Roh
Keyword(s):  
Patient Management ◽  
Needle Aspiration ◽  
Advanced Stage ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Molecular Tests ◽  
Molecular Studies ◽  
Advanced Stage Cancer ◽  
Ancillary Studies ◽  
Case Based

In patients with advanced-stage cancer, small biopsies including fine-needle aspirates may be the only opportunity to obtain diagnostic tissue. In the current era of precision medicine, there is an increasing emphasis on the performance of ancillary molecular tests that can provide insights into prognosis and targeted chemotherapeutic options for patient management. Cytopathologists must meet this challenge by accurately diagnosing these fine-needle aspirates and ensuring that adequate material has been obtained for anticipated molecular studies. Herein, we describe a case of a fine-needle aspiration illustrating these principles, especially focusing on the utilization of direct smears for ancillary studies.

Manufactured Cell Blocks: Turning Smears into Sections

2019 ◽  
Vol 63 (1) ◽  
pp. 28-34
Author(s):  
Alexandra Kang ◽  
Alina Miranda ◽  
Bastiaan de Boer
Keyword(s):  
Lymph Node ◽  
Soft Tissue ◽  
Molecular Analysis ◽  
Fine Needle Aspiration ◽  
Retrospective Review ◽  
Needle Aspiration ◽  
Dna Integrity ◽  
Fine Needle ◽  
Molecular Studies ◽  
Ancillary Studies

Whilst cytological smears are still the basis of cytodiagnosis, there is an increasing role for ancillary testing. Specimens obtained are not always optimal, often with limited material for ancillary studies. Several reports have described the utility of scraping material from cytological smears to manufacture cell blocks to provide material for ancillary studies. Our objective was a retrospective review of the PathWest (QE2) experience with manufactured cell blocks (mCB) over the last 10 years. A total of 178 fine-needle aspiration cases with mCB were extracted from the PathWest database. Data were subdivided into: lymph node (89), breast (31), thyroid (23), soft tissue (13), liver (11), and other sites (11) and were analysed. All available material was reviewed. Diagnostic material was identified in 163 mCB (91.6%). Immunohistochemistry (IHC) was performed on 149 cases. Positive IHC staining was seen in 139 cases (93.3%) and advanced the diagnosis in 119 cases (79.9%). Molecular studies were performed on 38 mCB with adequate DNA obtained in 37 cases (97.3%). Our review has demonstrated that cellular material scraped from air-dried or prefixed smears can be made into cell blocks. Antigen preservation is adequate to provide diagnostically useful results with IHC whilst DNA integrity is preserved to allow molecular analysis.

LYMPHOID INFILTRATION IN TOXIC GOITRES STUDIED WITH FINE NEEDLE ASPIRATION BIOPSY

1972 ◽  
Vol 71 (3) ◽  
pp. 480-490 ◽  
Author(s):  
Göran Nilsson
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Lymphoid Cells ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Needle Aspiration Biopsy ◽  
Lymphoid Infiltration ◽  
Long Acting

ABSTRACT Cytodiagnostic fine needle aspiration biopsy specimens from toxic goitres were studied for signs of lymphoid infiltration. Comparison with histological sections of specimens obtained by surgery showed that an excess of lymphoid cells in the aspirate smears corresponded to a large number of lymphoid foci in these sections. Excess of lymphoid cells in the fine needle aspirates was also positively correlated with the occurrence of circulating thyroid antibodies against thyroglobulin and/or cytoplasmic antigen, but not with the presence of the long-acting thyroid stimulating factor, LATS. It also varied with age in that it was most common in the youngest patients and in patients between 40–55 years, while lymphoid infiltration was seldom seen in patients over 55 years. A finding of practical clinical interest was that in toxic goitres with cytological signs of lymphoid infiltration hyperthyroidism had less tendency to recur after treatment with thiocarbamide drugs than in those without such signs.

scholarly journals Thyroglobulin measurements in washout of fine needle aspirates in cervical lymph nodes for detection of papillary thyroid cancer metastases

2010 ◽  
Vol 54 (6) ◽  
pp. 550-554 ◽  
Author(s):  
André B. Zanella ◽  
Erika L. Souza Meyer ◽  
Letícia Balzan ◽  
Antônio C. Silva ◽  
Joíza Camargo ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Cancer Metastases ◽  
Thyroid Cancer Metastases

OBJECTIVE: The aim of this study was to evaluate the accuracy of the measurement of thyroglobulin in washout needle aspiration biopsy (FNAB-Tg) to detect papillary thyroid cancer (PTC) metastases. SUBJECTS AND METHODS: Forty-three patients (51.4 ± 14.6 years) with PTC diagnosis and evidence of enlarged cervical lymph nodes (LN) were included. An ultrasound-guided fine-needle aspiration of suspicious LN was performed, for both cytological examination and measurement of FNAB-Tg. RESULTS: The median values of FNAB-Tg in patients with metastatic LN (n = 5) was 3,419 ng/mL (11.1-25,538), while patients without LN metastasis (n = 38) showed levels of 3.7 ng/mL (0.8-7.4). Considering a 10 ng/mL cutoff value for FNAB-Tg, the sensitivity and specificity was 100%. There were no differences on the median of FNAB-Tg measurements between those on (TSH 0.07 mUI/mL) or off levothyroxine (TSH 97.4 mUI/mL) therapy (3.3 vs. 3.8 ng/mL, respectively; P = 0.2). CONCLUSION: The results show that evaluation of FNAB-Tg in cervical LN is a valuable diagnostic tool for PTC metastases that can be used independent of the thyroid status.

Dilation of malignant esophageal stenosis to allow EUS guided fine-needle aspiration: safety and effect on patient management

2000 ◽  
Vol 51 (3) ◽  
pp. 309-313 ◽  
Author(s):  
Michael B. Wallace ◽  
Robert H. Hawes ◽  
Anand V. Sahai ◽  
Annette Van Velse ◽  
Brenda J. Hoffman
Keyword(s):  
Fine Needle Aspiration ◽  
Patient Management ◽  
Needle Aspiration ◽  
Esophageal Stenosis ◽  
Fine Needle

Cytotechnologist Performance for Screening Hürthle Cell Atypia in Indeterminate Thyroid Fine-Needle Aspirates

2015 ◽  
Vol 59 (5) ◽  
pp. 377-383 ◽  
Author(s):  
Christopher J. VandenBussche ◽  
Christina Adams ◽  
Syed Z. Ali ◽  
Matthew T. Olson
Keyword(s):  
Diagnostic Errors ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Hürthle Cell ◽  
Thyroid Fine Needle Aspiration ◽  
Hurthle Cells ◽  
Hürthle Cells ◽  
Almost All ◽  
Cell Atypia

Objectives: We have previously shown that specimens diagnosed as containing Hürthle cells have a 12% chance of being malignant if they are classified as atypia of undetermined significance (AUS-HC). The identification of Hürthle cells by cytotechnologists (CTs) during screening can improve cytopathologist efficiency and may prevent diagnostic errors due to the oversights of focal findings. Here, we examine the performance of our institutional CTs when screening for Hürthle cell atypia in thyroid fine-needle aspiration (FNA) specimens. Study Design: Information on 8,814 thyroid cytopathology specimens was retrieved for a 10-year period. Specimens were screened by 1 of 11 CTs. A subsample of cases was categorized either as AUS-HC or suspicious for Hürthle cell neoplasm. Results: AUS-HC screening diagnoses were more likely to be downgraded to benign but less likely to be upgraded compared to AUS diagnoses with nuclear or microfollicular atypia. AUS-HC represents almost all papillary thyroid carcinoma (PTC) screening diagnoses downgraded to the AUS category, which suggests that even low levels of Hürthle cell atypia can result in PTC being included in the differential diagnosis. Conclusion: Overall, there are few major discrepancies between CT and pathologist diagnoses for specimens containing Hürthle cell atypia.

scholarly journals Value of ancillary studies in the evaluation of fine-needle aspiration specimens: Our experience

2012 ◽  
Vol 29 (2) ◽  
pp. 103 ◽  
Author(s):  
D Mutreja ◽  
V Srinivasa ◽  
H Subramanya ◽  
VijayS Nijhawan ◽  
R Lakhtakia
Keyword(s):  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Ancillary Studies
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