Accuracy Of Fine Needle Aspiration Cytology Research Articles

Fine-needle aspiration of thyroid and diagnostic accuracy

BACKGROUND: Fine-needle aspiration cytology (FNAC) is widely considered as the gold standard in the assessment of thyroid lesions. The aim of this study is to determine the diagnostic accuracy of FNAC of thyroid lesions performed at our institution and correlate it with histopathological findings and also to compare our findings with that of studies from other regions of the world. MATERIALS AND METHODS: The present study is a 1-year prospective study of FNAC of thyroid lesions performed in the pathology department of our institution during January 2014–December 2014. The FNAC findings were correlated with the histopathological diagnosis, wherever available. The records of 236 patients who had undergone FNAC during the study period were followed by histopathological evaluation wherever possible. The cytological results were classified as inadequate, benign, suspicious, and malignant. The histopathology diagnosis was classified as nonneoplastic (benign) and neoplastic (malignant). RESULTS: The results of the FNA histological diagnosis showed that 6 (2.5%) of the patients had FNA, which were inadequate for cytological assessment, 222 (93.6%) patients had benign lesions, 4 (2.2%) had lesions that were suspicious for malignancy, and 4 (2.2%) had malignant neoplasm. CONCLUSIONS: The correlation of FNAC findings with the histopathological diagnosis showed that our FNAC diagnostic accuracy rate was 97.55% with a sensitivity of 85.75% and specificity of 100%. The results of our study are comparable with the previous studies done and showed that FNAC is a sensitive, specific, and accurate initial diagnostic test for preoperative evaluation of patients with thyroid swelling. It is recommended as the first-line investigation.

Diagnostic Efficacy of Fine Needle Aspiration Cytology and Cell Block Technique in Thyroid Lesions: A Hospital-based Study

Introduction: Fine Needle Aspiration Cytology (FNAC) and Cell Block are very commonly used initial tests for triaging thyroid lesions and play a pivotal role in deciding subsequent clinical management of thyroid nodules. In most cases, after excision, the diagnosis remains unchanged, but at times discordance does occur when benign lesions are reported on FNAC and cell blocks are found to be malignant on final histopathology and vice-versa. Aim: To assess the diagnostic efficacy of both FNAC and Cell Block technique in the evaluation of thyroid lesions by comparing their respective results with final histopathological diagnosis (after excision) in case of malignancies and clinico- radiological follow-up in benign cases. Materials and Methods: An observational hospital-based study was conducted in the Department of Pathology in a Tertiary Care Teaching Institute from 1st November, 2016 to 31st October, 2017. A total of 100 cases of thyroid masses were subjected to both FNAC and Cell Block and the diagnostic efficacy of both the techniques was assessed using MedCalc Statistical Software. Results: Mean age of the patients was 42.75±15.75 years with a range of 12-75 years. Females constituted 88% of the sample with male to female ratio of 1:7.3. 88% lesions were benign, 8% were malignant and 4% suspicious of malignancy on conventional smears in comparison to cell block which showed 90% benign, 8% malignant and 2% suspicious lesions. The validity of FNAC in terms of sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy was found to be 100%, 95.65%, 66.67%, 100.00% and 96.00% respectively, whereas for cell blocks these statistics were 100%, 97.83%, 80%, 100% and 98% respectively. Conclusion: Cell block improved the overall diagnostic accuracy of FNAC when used as an adjunct leading to 100% diagnostic yield. The results of this study also establish that FNAC and Cell blocks are sensitive, specific, and accurate as preliminary diagnostic tests for evaluation of patients with thyroid swellings. Moreover, their combined use can reduce the diagnostic errors and to improve the overall reporting efficacy. It is thus advised to perform cell block for each case of FNAC in thyroid lesions.

Fine needle aspiration cytology for parotid neoplasms: risk of malignancy through inconclusive results and lower grade tumors.

Fine needle aspiration cytology (FNAC) is a commonly performed procedure for parotid masses, although its accuracy in detecting malignancies widely varies through different series. We evaluated our single-center cohort of parotidectomies to highlight possible limitations of preoperative FNAC. Seven hundred and eighteen consecutive patients submitted to parotid surgery at San Raffaele Scientific Institute (Milan) were retrospectively evaluated (2002-2018). Five hundred and fifty four FNAC were analyzed. FNAC accuracy was assessed with and without inclusion of "inconclusive" results. The peculiar role of lower grade primary parotid cancers was investigated. FNAC reports were "diagnostic" in 502 cases (90.4%) and "inconclusive" in 52 (9.6%). Histopathology revealed 488 benign lesions (88.1%) and 66 malignancies (11.9%). FNAC sensitivity, specificity, PPV, NPV and accuracy in detecting malignancies were 59%, 99%, 89%, 95%, and 95%, respectively. Sensitivity fell to 48%, when "inconclusive" FNAC was computed. Within 66 parotid cancers, FNAC could discriminate malignancy in 32 cases (48.5%), provide proper grading in 21 (31.8%), and precise histopathological diagnosis in 15 (22.7%). Malignancy was more likely in patients with "inconclusive" FNAC than in those with "diagnostic" cytologies (23.1% vs 10.8%, p = 0.003). Low-intermediate-grade primary parotid cancers were associated to a higher rate of FNAC failure in comparison with high-grade ones (86.4% vs 19.0%; p < 0.001). FNAC is an important tool for preoperative assessment of parotid masses, though its sensitivity in detecting malignancy remains poor. "Inconclusive" FNAC results could further jeopardize FNAC accuracy and should elicit resorting to additional tests, especially when a lower grade parotid cancer is suspected.

IAC standardized reporting of breast fine-needle aspiration cytology, Yokohama 2016: A critical appraisal over a 2 year period.

Breast cytology is a significant component of the "Triple approach" for pre-operative diagnosis of breast lumps, the other two being clinical assessment and radiological imaging. The role of Fine needle aspiration cytology (FNAC) as a first line investigation in diagnosing breast lesions is well documented, however histopathology is the gold standard. Cyto-histopathological correlation is of great relevance and also increases precision.AIMS \& OBJECTIVES:The present study was conducted with the aim to categorize breast lesions according to the latest standardized reporting system proposed by International academy of cytologists (IAC) in 2016. Evaluation of diagnostic accuracy, sensitivity and specificity of FNAC in diagnosing breast lesions and cyto-histopathological correlation was planned. All FNAs of breast lesions over a period of 2 years were included in the study. The cases were grouped into five standardized categories proposed by the International academy of cytology: Category I (Insufficient material), Category II (Benign), Category III (Atypical, probably benign), Category IV (Suspicious, probably in situ or invasive) & Category V (Malignant) respectively. Specificity, sensitivity, diagnostic accuracy, negative and positive predictive value of FNAC were calculated and cyto-histopathological correlation assessed wherever possible. Out of 468 breast lesions reported on FNAC, the category wise distribution was - Category I, II, III, IV & V accounting for 23(4.9%), 342(73.07%), 7(1.5%), 11(2.35%) and 85(18.16%) respectively. Histopathology was performed in 331/468 cases with cyto histological concordance of 98.4% and a type agreement rate of 90.9%. The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy was 98.90%, 99.16%, 97.82%, 99.58% and 99.09% respectively. FNAC is a simple, reliable, cost effective, first line diagnostic procedure for all breast lumps. In collaboration with physical examination and imaging studies (triple approach), FNAC is a highly sensitive diagnostic tool. Adopting a universally acceptable standardized reporting system for breast cytology can enhance the diagnostic accuracy of FNAC.

Evaluation of the positive predictive value of atypical thyroid cytology cases according to the Bethesda system taking histopathology as gold standard.

Objectives: For the past 20 years Fine Needle Aspiration Cytology (FNAC) has evolved as the most sensitive diagnostic tool for the initial screening of patients with thyroid nodules. Unfortunately FNAC is complicated by a recognized false negative rate of approximately 5%. The clinicians could face the difficulty in the management of patient when a cytological diagnosis is atypical only. The objective of study is to evaluate the positive predictive value (PPV) of atypical thyroid cytology cases according to the Bethesda system taking histopathology as gold standard. Study Design: Cross sectional study. Setting: Department of Pathology at Shaikh Zayed Hospital, Lahore. Period: Six months i.e. from 25.11.2014 to 25.5.2015. Materials and Methods: Patients presenting with solitary thyroid nodules in the outpatient department and fulfilling the inclusion criteria were included after evaluation by thyroid function tests and thyroid scan, FNAC was performed and reported according to Bethesda system of thyroid reporting. Later on, cases underwent lobectomy, total or hemi-thyroidectomy, the tissue was received in 10% formalin solution in our pathology department and then processed, stained and examined. FNAC results of atypical cases were then compared with the definitive histological diagnosis which were considered the gold standard. The slides were examined and any differences were sought by consensus of two pathologists. Eighty cases were observed with 95% confidence level, 11% margin of error, using non-probability purposive sampling technique for sample collection. Data was analyzed by SPSS version 15 (P value &lt;0.05). Results: The mean age of patients was 38 years with SD ± 2.16. There were 22 (28%) males and 58 (72%) females in our study. In this study, positive predictive value for Atypia of undetermined significance/ Follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasm (FN), suspicious for malignancy and positive for malignancy were 33.3%, 25%, 66.6% and 100% respectively. Overall PPV of atypical cytology was 35.71%. Overall accuracy of FNAC was 86.30%, 87.50% sensitivity and 86.15% specificity, PPV value 43.75% and negative predictive value was 98.25%. Conclusion: Results showed that Bethesda system of reporting is helpful for the management of patients who falls in to undetermined categories as it categorically divide atypical cytology cases in to three definite categories AUS, FN and suspicious for malignancy and these categories have different risks of malignancy. Thus can help to determine a better patient outcome due to proper clinical management of thyroid swellings.

Fine needle aspiration cytology of epididymal nodules and its corroboration with ultrasonographic-histological findings.

Fine needle aspiration cytology (FNAC) assisted with scrotal ultrasonography is the best preoperative diagnostic modality for palpable epididymal nodules. It also aids in their successive remedial approach as well as serves semi-therapeutically in cystic lesions. The objectives of this study are to recognize the spectrum of pathological conditions giving rise to epididymal nodules, then to compare them with corresponding ultrasound images, and to evaluate the histological features wherever practicable. Total 62 patients underwent FNAC as well as sonographic evaluation for their epididymal nodules. Histopathology was performed in only 20 cases. Epididymitis either caused by tuberculosis (30.6%), or in its acute (11.3%) and chronic (8.1%) forms remained the commonest cytological diagnosis. Neoplastic lesions included mostly adenomatoid tumors (8.1%), and another case of seminomatous spread from ipsilateral testicular primary. Nineteen of the excised masses corroborated with their respective cytodiagnoses. The discrepant lesion was actually a papillary cystadenoma, which was cytologically misinterpreted as adenomatoid tumor. FNAC becomes the first-hand investigative measure for epididymal nodules, by virtue of its early, easy and highly accurate diagnostic implications. It segregates the patients into proper therapeutic protocol and thereby estranges those who really need operative management. When deployed together with ultrasound, the diagnostic accuracy of FNAC improves further.

Role of Fine Needle Aspiration Cytology in the Diagnosis Of Pleomorphic Adenoma With Histological Correlation

Background: Fine Needle Aspiration Cytology (FNAC) has been widely accepted as an accurate and minimally invasive diagnostic procedure in the investigations of salivary gland masses. The aim of this study was to determine the accuracy of FNAC in the diagnosis of pleomorphic adenoma. Materials and methods: A cross sectional comparative study was carried out on a total of 28 patients with salivary gland swellings who underwent preoperative FNA examination. After surgical excision of tumours, all FNAC findings were subsequently verified with histopathological examination. All the necessary and relevant data were recorded methodically and meticulously and statistical analysis was done by computer software device (SPSS-18 version). Results: On preoperative FNA examination, among the 28 cases, 19 (67.9%) cases were pleomorphic adenomas. On histopathological examination, out of 28 cases, 20 (71.4%) cases were pleomorphic adenomas. Out of 19 cases of pleomorphic adenomas diagnosed by cytology, 17 cases were confirmed by histopathology. Remaining two cases revealed different diagnosis. In three cases of pleomorphic adenomas diagnosed by histopathology, the cytology revealed different diagnosis. In six cases of tumours other than pleomorphic adenoma there was agreement between cytological and histological diagnosis. The diagnostic sensitivity, specificity and accuracy of preoperative FNAC of pleomor phic adenoma were 85%, 75% and 82.1% respectively. The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of FNAC were 89.5% and 66.7% respectively. Conclusion: Fine needle aspiration cytology is a useful preoperative diagnostic tool in evaluating Pleomorphic adenoma of salivary gland.&#x0D; JCMCTA 2019 ; 30 (1) : 56-60

Clinical characteristics of acinic cell carcinoma and secretory carcinoma of the parotid gland

Mammary analogue secretory carcinoma (SC) of the parotid gland is a relatively uncommon cancer associated with the ETV6-NTRK3 fusion product similar to breast cancer. The clinical characteristics and outcome of treatment were reviewed for patients with this tumor at our hospital. In this retrospective case series, 24 patients with a diagnosis of acinic cell carcinoma (AcCC) of the parotid gland were classified as having either SC or AcCC based on analysis of the ETV6-NTRK3 fusion gene. These two groups were compared with respect to their clinical and imaging characteristics (MRI/US), cytologic findings, accuracy of fine-needle aspiration cytology and frozen section, treatment outcomes, and immunohistochemical findings. Based on re-classification by ETV6-NTRK3 fusion gene analysis, the diagnosis was SC in 14 patients and AcCC in 10 patients. The SC group had a significantly higher proportion of male patients and was also significantly younger than the AcCC group. Imaging studies revealed that SC was significantly more likely to show internal heterogeneity. Correct grading of both tumors was comparable by fine needle aspiration, with the rate being 60% for AcCC and 50% for SC. Diagnosis by frozen section biopsy diagnosis obtained the correct grade in 90% of the AcCC group and 93% of the SC group. In 24 patients previously diagnosed with AcCC, re-analysis of the ETV6-NTRK3 fusion product indicated that 14 patients actually had SC. Although AcCC and SC show similarities of their biological aggressiveness and prognosis, patients with SC were significantly more likely to be male and younger.

Role of fine-needle aspiration cytology in the diagnosis of thyroid diseases

Background Fine-needle aspiration cytology (FNAC) is a gold standard investigation in the diagnosis of thyroid diseases. It is a simple, safe, cost-effective, and quick-to-perform procedure, with excellent patient compliance. It has high sensitivity, specificity, and accuracy as a preoperative investigation of thyroid gland diseases. Aim To determine the accuracy of FNAC in the diagnosis of thyroid diseases and to correlate the relationship between FNAC findings and histopathology of excised specimen. Patients and methods This was a prospective study conducted on 80 patients between September 2015 and September 2017. All patients with thyroid lesions were subjected to FNAC at Al Zahraa University Hospital. All patients with a clinically diagnosed solitary thyroid nodule, euthyroid multinodular goiter, and hypothyroid or hyperthyroid were excluded from this study. Results The study population was female predominant, represented by 73 (91.25%) patients, with age ranging from 18 to 65 years. Most cases were non-neoplastic, representing 42 (52.5%) cases, whereas 12 (15%) cases were neoplastic. The commonest lesion in thyroid gland was colloid goiter, and papillary carcinoma was the commonest among malignant lesion. On statistical analysis of our study, data showed the diagnostic accuracy of FNAC to be 80%, sensitivity to be 80%, and specificity to be 87.5% in neoplastic lesions, but results in carcinomatous lesions had accuracy of 92.5%, sensitivity of 80%, and specificity of 95.38%. Conclusion FNAC is an excellent first-line method as a preoperative investigation of thyroid swelling showing the nature of the lesion. It is a safe, minimally invasive, cost-effective diagnostic tool and correlates with the findings of tissue biopsy.

The influence of thyroid nodule size on the diagnostic efficacy and accuracy of ultrasound guided fine-needle aspiration cytology.

Diagnostic accuracy of fine-needle aspiration cytology (FNAC) in large and subcentimeter nodules is still debated. We aimed to evaluate the impact of nodule size on efficacy of the ultrasound-guided FNAC. B-mode grayscale ultrasound (US), US-guided FNAC according to Bethesda system and histopathological data of 514 nodules from 371 patients, who underwent thyroidectomy were examined retrospectively. Nodules were grouped by maximal diameter; group A nodules were smaller than 10 mm (n = 59), group B nodules were between 10 and 29 mm (n = 218), and group C nodules were 30 mm or greater (n = 130). Sensitivity, specificity, and accuracy of FNAC was 92.0%, 100%, and 95.1% in group A, 80.7%, 99.1%, and %92.9 in group B, 70.0%, 98.9%, and 95.8% in group C nodules, respectively. The prevalence of papillary thyroid cancer (PTC) and incidental PTC were 44.2% (n = 164) and 6.4% (n = 24), respectively. Malignancy rate was more frequent in group A when compared to groups B and C (P < 0.01). Nodule size was positively associated with follicular cancer risk (P = 0.009). The thyroid stimulating hormone level was positively associated with malignancy (P = 0.02) and optimal cut-off value was 0.96 mIU/L. False-negative rate was 8.0%, 19.3%, and 30.0% in groups A, B, and C nodules, respectively. Although the malignancy rate was low in nodules ≥30 mm, diagnostic surgery for large nodules should be considered because of decreased reliability of FNAC, ineffectiveness of clinical and sonographic criteria. False-negative rate was relatively low and malignancy rate was high in subcentimeter nodules, supporting the accuracy of FNAC.

Diagnostic accuracy and utility of fine-needle aspiration cytology in therapeutic management of parotid gland tumours

Introduction and objectivesThe utility of fine-needle aspiration cytology (FNAC) in parotid tumours remains widely debated. This study aims to evaluate the accuracy of FNAC in diagnosing parotid tumours. Materials and methodsWe performed a retrospective analysis of patients with tumour disease of the parotid gland treated at a Portuguese Oncology Institute, over a period of 25 years. The preoperative FNAC results were compared with the final histopathological diagnosis. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FNAC for malignancy. Association between malignancy on histopathology and FNAC results were evaluated with the Chi-square test. ResultsThe study sample consisted of 155 patients (77 males and 78 females) with a mean age of 56.6±17.0 years. In 27 cases (17.4%), the FNAC result was indeterminate. In this group of patients there was a higher proportion of malignancy on histology (48.1%) (X2; p<0.001). In the group with a conclusive result on FNAC, the sensitivity and specificity of FNAC for malignancy was 66.7% and 99.0%, respectively. PPV was 94.1% and NPV was 92.8%. ConclusionsA benign result on FNAC should be used with caution, due to its low sensitivity for malignancy. An indeterminate result on FNAC should raise suspicion for a malignant tumour.

Diagnostic accuracy and utility of fine-needle aspiration cytology in therapeutic management of parotid gland tumours

Introduction and objectivesThe utility of fine-needle aspiration cytology (FNAC) in parotid tumours remains widely debated. This study aims to evaluate the accuracy of FNAC in diagnosing parotid tumours. Materials and methodsWe performed a retrospective analysis of patients with tumour disease of the parotid gland treated at a Portuguese Oncology Institute, over a period of 25 years. The preoperative FNAC results were compared with the final histopathological diagnosis. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FNAC for malignancy. Association between malignancy on histopathology and FNAC results were evaluated with the Chi-square test. ResultsThe study sample consisted of 155 patients (77 males and 78 females) with a mean age of 56.6±17.0 years. In 27 cases (17.4%), the FNAC result was indeterminate. In this group of patients there was a higher proportion of malignancy on histology (48.1%) (X2; p<0.001). In the group with a conclusive result on FNAC, the sensitivity and specificity of FNAC for malignancy was 66.7% and 99.0%, respectively. PPV was 94.1% and NPV was 92.8%. ConclusionsA benign result on FNAC should be used with caution, due to its low sensitivity for malignancy. An indeterminate result on FNAC should raise suspicion for a malignant tumour.

Abstract P3-03-20: Which biopsy is preferred to stage the axilla under ultrasound guidance in early breast cancer patients: Fine-needle aspiration cytology or core needle biopsy?

Abstract Background: Preoperative axillary ultrasound (AUS) offers the potential to identify clinically axillary negative patients with axillary lymph node (ALN) metastasis directly to axillary lymph node dissection (ALND) with avoid of unnecessary sentinel lymph node biopsy (SLNB) except Z0011 candidates. Which biopsy should be preferred is pendent with lack of enough prospective studies. The purpose of our study was to compare the accuracy of ultrasound guided fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) for the designated ALN prospectively. Methods: Consecutive patients with histologically confirmed breast cancer from April, 2010 to December, 2014 were preliminary screened for our study. All the candidate patients were prospectively assessed by ipsilateral AUS before initial treatment regardless of clinical ALN status.Abnormal lymph nodes were characterized by round shape with uniform or eccentric thickening, focal bulging or irregularity of the cortex displacement, obliteration of the hilum; or total loss of recognizable lymph node architecture. If suspicious ALN was identified, both ultrasound-guided FNAC and CNB were performed for the same designated ALN.The diameter in longitudinal section, transverse section and maximum cortical thickness of the target node was recorded. When more than one abnormal lymph node was present, the most abnormal-appearing node was sampled. The target tissue for biopsy was hypoechoic thickened cortex. Patients with a positive FNAC/CNB underwent ALND, and those with a negative FNAC and CNB biopsy or without suspicious ALN by AUS underwent SLNB. The paired parameters of FNAC and CNB were compared using McNemar's exact test. Results: 705 consecutive patients were screened and 558 patients (561 axillae) underwent AUS evaluation with confirmed ALN pathological results.145 patients (146 axillae) with both FNAC and CNB were finally enrolled. Final histopathological results showed that 83.6% (122/146) were node positive (5 micro-metastases were considered negative). Sensitivity of FNAC and CNB was 67.2% (82/122) and 91.8% (112/122). Overall accuracy of FNAC and CNB was 72.6% (106/146) and 93.2% (136/146). Negative predictive value (NPV) of FNAC and CNB was 37.5% (24/64) and 70.6% (24/34). There was significant difference in sensitivity, overall accuracy and NPV between FNAC and CNB (p&amp;lt;0.001). 80.6% (29/36) FNAC negative and CNB positive patients have ALN cortical thickness of 3.3-7.2 mm. Conclusion: CNB is more sensitive and accurate than FNAC to stage the axilla under ultrasound guidance in operable breast cancer patients, especially in patients with ALN cortical thickness of 3.3-7.2 mm. Citation Format: Zhou M, Qiu J, Chen J, Hu Y, Deng Y, Zheng S. Which biopsy is preferred to stage the axilla under ultrasound guidance in early breast cancer patients: Fine-needle aspiration cytology or core needle biopsy? [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-20.

Values of fine-needle aspiration cytology of parotid gland tumors: A review of 996 cases at a single institution.

We evaluated the diagnostic accuracy of fine-needle aspiration cytology (FNAC) in a large series of benign and malignant parotid tumors. The FNAC diagnosis of 821 benign and 175 malignant parotid tumors managed at our department between 1999 and 2017 was correlated with the final histology. FNAC made a correct histopathological diagnosis in 72% of the benign parotid tumors; however, FNAC provided a correct grade in only 34% of the malignant tumors. FNAC correctly identified the histology of 94% of pleomorphic adenomas subsequently confirmed by histopathological examination. The sensitivity, specificity, and diagnostic accuracy of FNAC for detecting malignancy were 82.3%, 98.7%, and 95.9%, respectively. FNAC generally provided the correct histological diagnosis for benign tumors. However, the histological evaluation and grading of malignant tumors were poor. Although FNAC showed good sensitivity, specificity, and accuracy, its sensitivity decreased when nondiagnostic cases were included in the analysis.

Diagnostic Accuracy of Fine-Needle Aspiration Cytology for Discrimination of Squamous Cell Carcinoma from Adenocarcinoma in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Objective: To determine the accuracy with which morphology alone can distinguish adenocarcinoma and squamous cell carcinoma in non-small cell lung cancer. Methods: We performed a systematic review and meta-analysis. Three data bases (MEDLINE, EMBASE, Scopus) were searched for studies on the diagnostic accuracy of subtyping non-small cell lung cancer. Accuracy data was abstracted and synthesized using bivariate mixed effects logistic regression as implemented in the midas package in Stata 14. Heterogeneity was assessed using the Higgins I². Results: We included 17 studies (2,235 cases). Most studies had a low risk of bias. The pooled diagnostic accuracy for cytological diagnosis of adenocarcinoma resulted in a sensitivity of 63% (48–76%) and specificity of 95% (87–98%). The I² values were 93 and 88% for sensitivity and specificity, respectively. The pooled diagnostic accuracy for the cytological diagnosis of squamous cell carcinoma resulted in a sensitivity of 84% (79–88%) and a specificity of 90% (84–94%). The I² values were 69 and 86% for sensitivity and specificity, respectively. Conclusion: Accuracy varies widely by study and summary estimates do not provide a useful representation of accuracy. Squamous cell carcinoma was diagnosed more accurately than adenocarcinoma.

Diagnostic Accuracy of Fine Needle Aspiration Cytology in Lesions of Oral Cavity and Salivary Glands: A Clinico-Pathological Study.

Objective:Fine Needle Aspiration Cytology (FNAC) is a rapid, reliable and safe diagnostic tool used for various lesions of the oral cavity and salivary glands. The present study was undertaken to categorize the cytomorphology of the oral cavity and salivary gland lesions on FNAC and to assess the accuracy of FNAC in arriving at a diagnosis.Materials and Methods:A prospective study on oral cavity swellings and salivary gland aspirates was done during a 2 year period from August 2015 to July 2017 in which a total of 70 FNAC’s were performed. There were 12 aspirates obtained from oral cavity swellings and 58 aspirates were obtained from salivary glands. Histopathological evaluation of 65 lesions was done and was considered as gold standard. Only the lesions undergoing histopathological confirmation were included in the study. The sensitivity, specificity, diagnostic accuracy and clinical utility index were evaluated for accuracy of FNAC.Results:Hard palate (33.33%) was the predominantly aspirated site in the oral cavity. Parotid gland was the predominant gland aspirated (60.32%) among the involved salivary glands. Non-neoplastic lesions constituted 18.47% cases whereas neoplastic lesions were 81.53% (60.00% benign and 21.53% malignant). Pleomorphic adenoma (28.65%) was the most common benign lesion in the oral cavity involving hard palate and as salivary gland neoplasm (70.54%). Squamous cell carcinoma (60%) was the most common malignant lesion of oral cavity involving the tongue and buccal mucosa and adenoid cystic carcinoma (44.45%) was the commonest malignancy in salivary gland malignant neoplasms. The overall sensitivity, specificity and accuracy of FNAC in the present study were 89.5%, 100% and 85% respectively.Conclusion:FNAC is a safe, cost-effective and reliable technique effective in diagnosing the spectrum of different lesions in the oral and maxillofacial region.

Diagnostic Accuracy of Fine-needle Aspiration Cytology Performed in a One-stop Clinic for the Diagnosis of Breast Lesions

Diagnostic Accuracy of Fine-needle Aspiration Cytology Performed in a One-stop Clinic for the Diagnosis of Breast Lesions

Diagnostic Value of Fine Needle Aspiration Cytology in the Assessment of Cervical Lymphadenopathy

Background: Cervical lymphadenopathy is one of the most frequent clinical manifestations of patients attending outpatient department. The etiology of cervical lymphadenopathy varies from inflammatory condition to malignant lesion. Fine needle aspiration cytology (FNAC) is a safe, easy and quick diagnostic technique. It has become the first line of investigation in the evaluation of lymphadenopathy. The objective of this study was to evaluate the spectrum of lesions in cervical lymphadenopathy and role of FNAC in the diagnosis of cervical lymphadenopathy.Methods: This study was conducted over a period of two years (May 2015 to May 2017). 206 patients with cervical lymphadenopathy were included in the study.Results: Most of the cases were non-neoplastic (91.74 %) whereas (8.26 %) cases were neoplastic. The most common cause of non-neoplastic lymphadenopathy was reactive lymphadenitis. Histocytological correlation was done in 32 cases. The diagnostic accuracy of FNAC for metastatic carcinoma and reactive lymphadenitis was 100% and 93.75% respectively.Conclusions: FNAC is a safe, cost effective and reliable procedure to diagnose the causes of cervical lymphadenopathy.Med Phoenix. Vol. 3, Issue. 1, 2018, Page: 36-40

Fine needle aspiration cytology accuracy in diagnosis of thyroid lesions: a comparative study with histopathological examination of thyroid swellings

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Thyroid enlargement, whether diffuse or in the form of a nodule, leads to a battery of investigations to be done. Fine needle aspiration cytology (FNAC) is usually the first line of investigation but the limitations of cytology are well recognized in the diagnosis of some thyroid malignancies, in particular it is not able to differentiate between follicular adenoma and carcinoma. We conducted a prospective study to assess the role of FNAC in diagnosing the nature of thyroid swelling and comparing its result with histopathology finding.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This was a prospective study conducted on 100 consecutive patients presented with thyroid swelling in department of otorhinolaryngology. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The present data show high specificity (96.29%) of FNAC as compared to sensitivity, which came out to be (78.9%). Positive and negative predictive value is 93.75% and 95.23%. This is quite similar to previous studies.&lt;/p&gt;&lt;p class="p1"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; FNAC has high specificity (96.29%), sensitivity (78.9%), positive predictive value (93.75%), negative predictive value (95.23%) and accuracy (95%) therefore it can be reliably used as initial investigation. A benign FNAC diagnosis should be viewed with caution as false negative results do occur and these patients should be followed up clinico-radiologically for any progression that will require repeated FNAC and/or surgery. &lt;/p&gt;

Evaluation of fine needle aspiration cytology in the diagnosis of cervical lymph node lymphomas

PurposeSurgical biopsy examination is the gold standard for the diagnosis of lymph node lymphomas. Fine-needle aspiration cytology (FNAC) is a quick and safe method in the management of cervical lymph nodes. Its value in confirming recurrent or residual lymphoma is well established. However, its role in the primary diagnosis of lymph node lymphoma remains controversial. The aim of this study was to assess, in our experience, the reliability of FNAC in the diagnosis of cervical lymph node lymphomas. Materials and methodsThis was a retrospective study carried out over a 6-year period (January 2011 to December 2016) and conducted at the Cytology Unit in our Pathology Department (Charles Nicolle Hospital, Tunisia). The measures of diagnostic accuracy of FNAC in the diagnosis of cervical lymph node lymphomas were calculated taking histopathology as the gold standard. ResultsA total of 937 FNA samples were obtained from 851 patients. The diagnosis of lymphoma was obtained in 65 cases (6.9%). Cytological diagnoses of lymphoma were as follows: 28 (44%) Hodgkin lymphoma, 17 (25%) high-grade lymphoma, 15 (23%) low-grade lymphoma, and 5 (8%) “suggestive of lymphoma.” FNAC of cervical lymph nodes had a sensitivity of 95.5%, specificity of 98.7%, positive predictive value (PPV) of 97.7%, and negative predictive value (NPP) of 97.5%. ConclusionThe present study demonstrated that cytology is capable to detect nodes suspicious for the presence of lymphoma precisely, in terms of low- or high-grade lymphoma, which is a relevant and very achievable first step in the management of patients with cervical lymph node lymphoma.