Fine Needle Capillary Sampling Research Articles

ULTRASOUND GUIDED FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) VERSUS FINE NEEDLE CAPILLARY SAMPLING (FNCS) OF THYROID NODULES

Sampling of non-palpable thyroid nodule under ultrasound guidance has been widely used, however less studies done in comparing the efficacy of technique between fine needle aspiration cytology (FNAC) and fine needle capillary sampling (FNCS) under ultrasound guidance.

Ultrasound-Guided Fine-Needle Aspiration Versus Fine-Needle Capillary Sampling in Evaluation of Lymph Node Metastasis of Thyroid Cancer.

BackgroundTo compare the sampling adequacy and diagnostic efficiency of ultrasound-guided fine-needle aspiration with 22-, 25-gauge needles and capillary sampling with 22-gauge needle in the biopsy of cervical lymph node.MethodsA total of 130 cervical lymph nodes from 103 patients were consecutively included in the prospective study. Each suspected lymph node was aspirated with a 22-gauge needle, capillary sampled with a 22-gauge needle and aspirated with a 25-gauge needle. The adequacy rates and nondiagnostic rates of obtained specimen were calculated.ResultsOf the 130 suspected lymph nodes, there were 77 lymph nodes<6.0 mm and 53 lymph nodes≥6.0mm in the smallest dimension. Both FNA22G and FNC22G got significantly higher sampling adequacy than FNA25G for the total lymph nodes. For lymph nodes<6.0 mm, the sampling adequacy was significantly higher with FNA22G than with FNA25G for each parameter and the cumulative score (all P<0.05), while no difference were seen between FNA22G and FNC22G, and between FNC22G and FNA25G. There were higher nondiagnostic rates for FNA25G compared with FNA22G and FNC22G in all lymph nodes and in each size subgroups. FNA25G yielded more diagnostically inadequate specimens than FNA22G and FNC22G did in the total lymph nodes (P=0.002), in lymph nodes<6.0 mm (P=0.014), and in those ≥ 6.0 mm (P=0.000).ConclusionsFNA22G and FNC22G obtained more diagnostically adequate specimens than FNA25G in cervical lymph nodes. FNA22G and FNC22G may be more suitable than FNA25G in diagnosing cervical lymph nodes. FNA22G and FNC22G may yield specimens with similar quality.

Fine Needle Aspiration versus Fine Needle Capillary Sampling Technique in Cyto-diagnosis of Thyroid Lesions

Introduction: In diagnosis of thyroid lesions, the negative pressure applied during fine needle aspirationcytology (FNAC) frequently produces bloody smears. This results in a compromise in cellular concentrationand architecture which may lead to improper interpretation. Fine needle capillary sampling cytology(FNCC), on the other hand, avoids active aspiration as it depends on capillary tension to collect tissuesamples in the needle bore. This study evaluated the diagnostic performance of FNAC and FNCC in thyroidlesions. Methods: A total of 120 patients were included in this study conducted over a duration of 19months. All thyroid swellings advised for cyto-diagnosis were sampled by both fine-needle aspiration(FNAC) and non-aspiration (FNCC) techniques. The slides were assessed according to the Mair et al.scoring system. Results: In the FNCC group, 72 (60%) smears were diagnostically superior while 54 (45%)smears were diagnostically superior in the FNAC group. Blood contamination (p=0.003), cellular trauma(p=0.019), and degree of cellular degeneration (p=0.026) were less and cellular architecture (p=0.047) waspreserved more in FNCC in comparison to FNAC groups. Conclusion: This study showed the superiority ofFNCC for the interpretation and diagnosis of thyroid lesions. However, the combination of both FNAC andFNCC could maximize the diagnostic yield.

Fine Needle Aspiration Cytology versus Fine Needle Capillary Sampling in Cytological Diagnosis of Thyroid Lesions.

Fine needle aspiration cytology (FNAC) is an established out- patient procedure used in primary diagnosis of palpable thyroid lesions. A modified technique fine needle capillary sampling (FNCS) obviates the need of suction, is less painful, patient friendly and reported to overcome the problem of inadequate and bloody specimens. The aim of our study was to compare the efficacy and quality of FNCS with that of conventional FNAC in the lesions of thyroid. One hundred patients, presenting between January 2011 to December 2012 at Cytopathology Department of M M Institute of Medical Sciences and Research, Mullana, with diffuse and nodular thyroid lesions were enrolled with both the techniques being executed on the patients, beginning with FNA followed by FNCS. The smears were scored using five objective parameters i.e. background blood, cellular material, cellular degeneration, cellular trauma, and retention of appropriate architecture, in a single blind setting by a cyto-pathologist. The results were analyzed using Student's test for paired data and chi- square analysis. A highly significant differences (P<0.001) in favor of FNCS was observed for the background blood, cellular material and retention of architecture while total score favored FNA for cellular degeneration and degree of cellular trauma. Total scores and average score per case for FNCS was significantly better (P<0.001) than FNA. FNCS technique yielded more diagnostically superior and lesser number of unsatisfactory smears whereas greater number of diagnostically adequate samples was obtained by FNA technique. FNCS offers more number of diagnostically better quality smears. Both techniques could be supplementary on many occasions and substitutive on a few. Combination of the two techniques could offer better diagnostic accuracy.

Comparison of fine‐needle aspiration and fine‐needle capillary sampling of thyroid nodules: A prospective study with emphasis on the influence of nodule size

The objective of this study was to compare the sampling efficiency of ultrasound-guided fine-needle aspiration (FNA) and fine-needle capillary (FNC) sampling in thyroid nodules, in which the authors specifically analyzed the influence of nodule size. This study included 280 thyroid nodules in 275 consecutive patients. The nodules were divided into 4 size subgroups: ≤5.0 mm, from 5.1 to 10.0 mm, from 10.1 to 20.0 mm, and >20.0 mm. Each nodule was sampled by both FNA and FNC. The final cytopathologic findings were reported. The smears were scored and then categorized as diagnostically inadequate, adequate, or superior on the basis of 4 parameters, which included background clot or blood, the number of obtained cells, preserved tissue architecture, and cellular degeneration. The κ scores for agreement of the cytopathologic results between FNA and FNC sampling in the 4 size subgroups were 0.377, 0.455, 0.751, and 0.352 for nodules that measured ≤5.0 mm, from 5.1 to 10.0 mm, from 10.1 to 20.0 mm, and >20.0 mm, respectively. The proportion of nondiagnostic of FNAs was significantly lower than the proportion of nondiagnostic FNC samples in nodules that measured >20.0 mm (P = .037). Scores for the 4 diagnostic parameters were significantly greater in FNAs than in FNC samples in nodules that measured from 5.1 to 10.0 mm and >20.0 mm (all P < .05); however, similar results were not observed in the nodules that measured ≤5.0 mm or from 10.1 to 20.0 mm (all P > .05). Also, FNA yielded significantly more diagnostically superior specimens than FNC sampling in nodules that measured from 5.1 to 10.0 mm and >20.0 mm (P < .05 for both). The current findings indicated that FNA may be more suitable than FNC for sampling nodules that measure from 5.1 to 10.0 mm and >20.0 mm; whereas, for nodules that measure ≤5.0 mm and from 10.1 to 20.0 mm, the 2 techniques could yield specimens with similar quality.

Low Nondiagnostic Rate for Fine‐Needle Capillary Sampling Biopsy of Thyroid Nodules

This study examined the hypothesis that sonographically guided fine-needle capillary thyroid biopsies performed by an experienced operator and with constant technique on nodules that meet the Society of Radiologists in Ultrasound criteria warranting biopsy can result in a nondiagnostic rate that is significantly lower than prior published reports. We retrospectively reviewed the sonographic and pathologic reports from 228 consecutive sonographically guided fine-needle capillary thyroid biopsies performed during a 3-year interval by a single operator with more than 15 years of experience performing fine-needle capillary thyroid biopsies. There were no exclusion criteria. Sonographic and pathologic reports from all nodules biopsied were included in the analysis. The radiologist's protocol included 6 fine-needle capillary biopsies, each with 20 passes of the needle into the periphery and/or solid components of the nodule. The cytologic specimens were reviewed off-site in adherence with the Bethesda system for reporting thyroid cytopathologic findings and classified as diagnostic or nondiagnostic. The nondiagnostic rate in this study was compared with the nondiagnostic rates in prior published reports. Among the 228 fine-needle capillary thyroid biopsies performed during the study interval, cytologic analysis showed 1 nondiagnostic biopsy, yielding a nondiagnostic rate of 0.4%. This rate was significantly lower than previously published reports (P < .001). Sonographically guided fine-needle capillary biopsies of the thyroid performed by an experienced radiologist can result in a nondiagnostic rate of less than 1%. This finding warrants further investigation into the reasons for the discrepancy between the results of this study and other previous reports.

Modified Technique for Obtaining Mediastinal Samples With Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: Results From a Prospective Observational Study

BackgroundEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely-accepted method for obtaining both benign and malignant mediastinal lymph node samples. We present the results obtained with a modification that simplifies sampling, known as fine-needle capillary sampling or EBUS-FNC. MethodsA prospective observational study with 44 consecutive patients who underwent EBUS at the University of Navarra Clinic in Pamplona, Spain. All samples were obtained by EBUS-FNC instead of by conventional EBUS-TBNA. No suction was used, and the internal stylus was not completely withdrawn at any time. ResultsThe examination of the mediastinum by means of EBUS identified the presence of lymphadenopathies or mediastinal masses in 38 patients (86.4%). Samples were taken from more than one lymph node in 23 patients (52.3%). EBUS-FNC provided adequate and representative material for interpretation in all patients, and diagnostic performance was 87%. Sensitivity for the detection of lung cancer with EBUS-FNC was 84%. Mild complications were only recorded in two patients (4.5%). ConclusionsOur study suggests that EBUS-FNC is a safe technique, comparable to EBUS-TBNA in efficacy, and is able to obtain adequate samples.

Técnica modificada de obtención de muestras del mediastino mediante punción transbronquial bajo guía de ecografía endobronquial: resultados de un estudio prospectivo observacional

BackgroundEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely-accepted method for obtaining both benign and malignant mediastinal lymph node samples. We present the results obtained with a modification that simplifies sampling, known as fine-needle capillary sampling or EBUS-FNC. MethodsA prospective observational study with 44 consecutive patients who underwent EBUS at the University of Navarra Clinic in Pamplona (Spain). All samples were obtained by EBUS-FNC instead of by conventional EBUS-TBNA. No suction was used, and the internal stylus was not completely withdrawn at any time. ResultsThe examination of the mediastinum by means of EBUS identified the presence of lymphadenopathies or mediastinal masses in 38 patients (86.4%). Samples were taken from more than one lymph node in 23 patients (52.3%). EBUS-FNC provided adequate and representative material for interpretation in all patients, and diagnostic performance was 87%. Sensitivity for the detection of lung cancer with EBUS-FNC was 84%. Mild complications were only recorded in two patients (4.5%). ConclusionsOur study suggests that EBUS-FNC is a safe technique, comparable to EBUS-TBNA in efficacy, and is able to obtain adequate samples.

Mo1396 Endoscopic Ultrasound-Guided Fine Needle Aspiration Versus Fine-Needle Capillary Sampling Biopsy of Pancreatic Solid Lesions: Does Technique Matter?

Mo1396 Endoscopic Ultrasound-Guided Fine Needle Aspiration Versus Fine-Needle Capillary Sampling Biopsy of Pancreatic Solid Lesions: Does Technique Matter? Ann M. Chen, Walter G. Park, Shai Friedland, Subhas Banerjee Gastroenterology, Stanford University School of Medicine, Palo Alto, CA Background: Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) is a sensitive and safe procedure for evaluation of solid lesions of the pancreas. However, an accurate diagnosis is highly dependent on the quality of the specimen obtained. Although the procedure is increasingly performed, aspiration technique varies greatly among endosonographers with no studies comparing the results. Aspiration with a syringe suction is one of the more common techniques used currently. A more novel biopsy method employed by radiologists in percutaneous FNA of the thyroid utilizes only capillary aspiration created by slow withdrawal of the stylet. It is not know if this technique may also provide higher yield in EUS-FNA of solid pancreas lesions. Methods: A retrospective study of patients at our institution undergoing EUS-FNA of solid pancreatic masses from August 2008 to November 2010 was performed. Final cytology report was compared with subsequent surgical histopathology or longterm clinical follow-up. Results: A total of 91 patients with solid pancreatic masses underwent EUS-FNA using either the stylet capillary sampling (CS) technique (n 45) or a 5ml syringe suction (SS) method(n 46) were identified. The sensitivity, specificity, PPV, and NPV were 94%, 100%, 100%, and 88%, respectively for CS compared to 80%, 100%, 100%, and 71%, respectively for SS. While there was a trend toward more superior diagnostic performance with CS, a statistical significance was not reached in this small study (P 0.13). Of the 6 patients who had non-diagnostic SS aspirates, final diagnosis of adenocarcinoma (n 5) or neuroendocrine tumor (n 1) was found by percutaneous biopsy (n 2), surgery (n 2), or bile duct brushings. Of the 2 patients in the CS group with initial non-diagnostic biopsies, one underwent repeat biopsy with the CS technique which revealed adenocarcinoma. The other patient with severe pancreatitis had atypical cytology. Subsequent surgery confirmed suspicion of adenocarcinoma. The mean number of needle passes required for diagnosis was the same (n 3.4) for both techniques but the quality of the cytology specimen graded by blinded pathologists was abundantly cellular in 55% of CS specimens compared to only 33% of the SS samples. This difference was observed despite smaller mean size of pancreatic lesions sampled by CS (mean 2.2cm, 95% CI 1.72.7) compared to those sampled by SS (mean 3.2cm, 95% CI 2.8-3.7). Limitations: Single-center retrospective study Conclusions: Fine needle capillary sampling technique appears to be more sensitive and has a higher NPV than suction aspiration of solid pancreas lesions. Higher quality of cytology smear is observed with the capillary methoid which may be a result of reduced tissue trauma and less bloody aspirate. Further prospective randomized studies of this promising technique are warranted.

How Diagnostic Is Ultrasound-Guided Neck Mass Biopsy (Fine-Needle Capillary Sampling Biopsy Technique)?

The purpose of this study was to evaluate the diagnostic value of ultrasound-guided neck mass biopsy (fine-needle capillary sampling biopsy [FNC] technique). With Institutional Review Board approval, all patients who had an ultrasound-guided neck mass FNC biopsy between January 2000 and December 2006 were retrieved from the ultrasound database. A total of 132 neck mass biopsies were performed in 124 patients. Patient demographics, procedure characteristics, and pathologic diagnoses were recorded. Of the 124 patients, 73 were female (mean age, 51.4 years). Biopsies were performed twice in 8 patients. A significant 200% increase from 2000 through 2002 to 2003 through 2004 and from 2003 through 2004 to 2005 through 2006 was found (P < .05). The most biopsied location was in the lymph nodes (34.8%), followed by perithyroid soft tissue masses (28.0%). A 25-gauge needle was used most frequently (97.7%). A total of 41 biopsies were diagnostic for thyroid diseases (31.1%), with the most common being thyroid papillary carcinoma. We found metastases in 31 biopsies (23.5%). Following these 2 were 29 lymph node biopsies. No major complications were noted. Of the 132 neck masses biopsied, 8 were pathologically nondiagnostic (93.9% diagnostic yield), yielding sensitivity, specificity, and accuracy of greater than 95% (97.1%, 95.2%, and 95.8%, respectively). Ultrasound-guided FNC of neck masses is highly diagnostic. The diagnostic yield is especially high for detection of malignancy, including metastases. Together with a high clinical suspicion, ultrasound-guided needle biopsy should be performed to form a correct diagnosis and make appropriate management plans.

Unsatisfactory Consequences from Fine-Needle Aspiration Biopsy of Thyroid Nodules

ThyroidVol. 18, No. 5 Editorials and CommentaryUnsatisfactory Consequences from Fine-Needle Aspiration Biopsy of Thyroid NodulesAngela M. Leung and Alan P. FarwellAngela M. LeungSearch for more papers by this author and Alan P. FarwellSearch for more papers by this authorPublished Online:8 May 2008https://doi.org/10.1089/thy.2008.0067AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "Unsatisfactory Consequences from Fine-Needle Aspiration Biopsy of Thyroid Nodules." , 18(5), pp. 491–492FiguresReferencesRelatedDetailsCited bySuperficial Aspiration TechniqueLow Nondiagnostic Rate for Fine-Needle Capillary Sampling Biopsy of Thyroid Nodules1 December 2013 | Journal of Ultrasound in Medicine, Vol. 32, No. 12Percutaneous Laser Ablation of Cold Benign Thyroid Nodules: A 3-Year Follow-Up Study in 122 Patients Roberto Valcavi, Fabrizio Riganti, Angelo Bertani, Debora Formisano, and Claudio M. Pacella9 November 2010 | Thyroid, Vol. 20, No. 11Is fine-needle aspiration cytology for thyroid nodules a routine and safe procedure? A series of emergency cervicotomies following FNAC23 July 2010 | Langenbeck's Archives of Surgery, Vol. 395, No. 7Alterations in Serum Thyroid–Related Constituents After Thyroid Fine-Needle Biopsy: A Systematic Review Stergios A. Polyzos and Athanasios D. Anastasilakis28 February 2010 | Thyroid, Vol. 20, No. 3Adequacy and Diagnostic Accuracy of Aspiration vs. Capillary Fine Needle Thyroid Biopsies15 September 2009 | Endocrine Pathology, Vol. 20, No. 4Clinical complications following thyroid fine-needle biopsy: a systematic reviewClinical Endocrinology, Vol. 71, No. 2Perchlorate: a cause for iodine deficiency?Environmental Chemistry, Vol. 6, No. 1 Volume 18Issue 5May 2008 InformationCopyright 2008, Mary Ann Liebert, Inc.To cite this article:Angela M. Leung and Alan P. Farwell.Unsatisfactory Consequences from Fine-Needle Aspiration Biopsy of Thyroid Nodules.Thyroid.May 2008.491-492.http://doi.org/10.1089/thy.2008.0067Published in Volume: 18 Issue 5: May 8, 2008Online Ahead of Print:April 21, 2008PDF download

Ultrasound-Guided Fine-Needle Aspiration Versus Fine-Needle Capillary Sampling Biopsy of Thyroid Nodules

Both fine-needle aspiration (FNA) and fine-needle capillary (FNC) sampling of palpable thyroid nodules have been advocated. The appropriate technique for biopsy of nonpalpable nodules now sampled under ultrasound guidance has not been assessed. The objective of this study was to determine cytologic adequacy rates of ultrasound-guided FNA and FNC sampling. Ultrasound-guided fine-needle biopsy was performed on 180 thyroid nodules. Nodules were measured and characterized (mixed cystic-solid or solid) on diagnostic sonography. The technique used for biopsy (FNA versus FNC sampling) alternated sequentially per patient. Four 25-gauge fine-needle samples were obtained from each nodule. The sampling adequacy and cytopathologic diagnoses were recorded. The significance of differences in cytologic adequacy rates between techniques was then assessed with a repeated measures logistic regression model. Fine-needle aspiration and FNC sampling biopsies were performed in 88 and 92 nodules, respectively. Fine-needle aspiration was diagnostic (ie, satisfactory) in 78 (89%) of 88 nodules and nondiagnostic (less than optimal or unsatisfactory) in 10 (11%) of 88 nodules; FNC sampling was diagnostic in 80 (87%) of 92 nodules and nondiagnostic in 12 (13%) of 92 nodules. Fine-needle aspiration sampling was diagnostic in 38 (86%) of 44 solid nodules and 40 (91%) of 44 mixed cystic-solid nodules; FNC sampling was diagnostic in 48 (81%) of 59 solid nodules and 32 (97%) of 33 mixed cystic-solid nodules. These percentages were not significantly different. Ultrasound-guided FNA and FNC sampling result in comparable diagnostic cytologic adequacy rates. Equivalent diagnostic yields and the technical ease of capillary sampling may prompt adoption of FNC sampling at high-volume endocrine/radiology practices.

Evaluation of Fine Needle Aspiration vs. Fine Needle Capillary Sampling on Specimen Quality and Diagnostic Accuracy in Endoscopic Ultrasound–Guided Biopsy

To compare percutaneous and endoscopic ultrasound (EUS)-guided biopsy techniques.From July 2005 to February 2006, all patients referred for EUS-guided fine needle aspiration (FNA) were considered. If inclusion criteria were met, the first 2 biopsy passes were performed without suction (fine needle capillary [FNC] sampling). Two additional passes were performed using the same needle with 10 mL of applied suction (FNA). A single blinded pathologist later retrospectively evaluated each set of slides. Fifty-three patients met inclusion criteria. The study group comprised pancreatic masses (23), lymph nodes (26), subepithelial masses (3) and liver lesion (1). There were 38 malignant and 15 benign lesions.No statistically significant differences were found with the scoring systems considered in the study. In the subgroups of patients with pancreatic masses, lymph nodes, benign disease and malignant disease, no statistically significant outcomes were noted.No difference exists between quality and diagnostic accuracy of specimens obtained from EUS-guided tissue acquisition via FNC and FNA. The decision to use FNC or FNA should be left to the discretion of the individual endosonographer.

Prospective Evaluation of Fine Needle Aspiration (FNA) Versus Fine Needle Capillary Sampling (FNC) On Specimen Quality and Diagnostic Accuracy in EUS-Guided Biopsy

Background and Aim: Standard EUS-FNA utilizes 10cc of suction to draw tissue into the biopsy needle. Recent data has suggested that high power suction may improve sample yield. Studies from the radiology literature, however, suggests that FNC (i.e. FNA without suction) may yield a higher quality sample secondary to less trauma to the tissue and less blood. The aim of our study was to compare a technique of FNA with that of FNC during EUS tissue sampling to determine if there is a difference in specimen quality and diagnostic accuracy. Methods: From May 2005 to October 2005 30 consecutive patients who were referred to our center for EUS-FNA were included. The average age was 65 yrs (range 32-77 yrs) with 10F and 20M. The study group was comprised of: pancreatic masses (12); lymph nodes (16) and submucosal masses (2). There were 17 malignant and 13 benign lesions in the study. EUS was carried out using the Olympus GF-UC140P linear array echoendoscope and FNA was performed using a 22-gauge cytology needle. The echoendoscope was positioned so that sampling could be performed along the longest possible lymph node or mass diameter. In each patient, the first two passes were made without suction (FNC). The needle was vigorously flushed with 20 cc of normal saline. Two addition passes were then performed using the same needle after 10 cc of suction was applied. Additional passes for diagnostic purposes were made as necessary at the discretion of the endosonographer, but these were not included in the study. No on-site cytopathologist was present. A single blinded pathologist later evaluated each set of slides for background blood or clot, amount of cellular material, degree of cellular degeneration and degree of cellular trauma based on a previously studied scale (scores 0-2 for each parameter). The results were compared using the Wilcoxon Matched-Pairs Signed-Ranks Test. Results: There was no statistically significant difference in any of the criteria evaluated between FNA and FNC (p = 0.7). Pooled analysis of all criterias and overall accuracy were similar (p = 0.3) In the subgroup of patients with pancreatic masses and lymph nodes there was no difference (p = 0.7). Conclusions: Our data suggests that FNC is, at best, equivalent to FNA in the quality and accuracy of the obtained specimen during EUS tissue acquisition. Although more data is needed, our preliminary data suggests that future research should focus on higher amounts of suction for tissue acquisition rather than FNC.

Fine Needle Capillary Sampling of Eyelid Masses

To study the cytomorphology of eyelid tumors, correlate it with histopathology and determine the diagnostic accuracy of fine needle capillary (FNC) sampling (nonaspiration) in the evaluation of lid tumors. A prospective study of 70 cases of eyelid masses carried out using FNC, with confirmation by histology in 66 cases and peripheral blood smear and bone marrow examination in 3. Histology was not done in 1 case, and 11 cases were inadequate on cytology. The diagnostic accuracy of cytology was 94.73%, and false negativity was 5.17%. The ages of the patients ranged from 3 to 75 years, with a mean of 40.4. The male/female ratio was nearly equal (37:33). The upper eyelid was affected in 45 cases and lower lid in 25 cases. The right eye was affected in 35 cases, left eye in 34 cases and both eyes in 1 case. Fifteen benign, 35 malignant and 9 infectious/inflammatory lesions were encountered, with 11 inadequate smears. FNC sampling is an effective method of sampling eyelid tumors because it causes little discomfort to the patient and allows the operator to maintain better control over the procedure. A distinction between inflammatory, benign and malignant lesions and between the types of malignant tumors can be made.

Comparative Study of Fine Needle Aspiration and Fine Needle Capillary Sampling of Thyroid Lesions

To investigate whether fine needle capillary (FNC) sampling gives quantitatively and qualitatively superior cytologic material as compared to the conventional technique of fine needle aspiration (FNA) when performed by a single aspirator. Cross-sectional diagnostic test evaluation study. FNA and FNC were performed by a single operator on 200 diffuse and nodular thyroid lesions. A statistically significant difference in favor of FNC was observed for the parameter amount of cellular material. For the rest of the parameters--background blood or clot, degree of cellular degeneration, degree of cellular trauma and retention of architecture--the average score favored FNC but was not statistically significant--i.e., smears prepared from FNC displayed cellular material that was more concentrated, less damaged and less likely to be obscured by blood. Although FNC sampling was diagnostic in a greater number of cases than FNA sampling, this study did not prove a clear superiority of FNC over FNA. Until greater experience shows clear sampling superiority of FNC alone, rather than performing only FNA in diffuse or nodular thyroid lesions, incorporating FNC into the second puncture will definitely improve the quality and quantity of material at the patient's first visit.

Fine needle capillary sampling (non aspiration technique) vs conventional FNAC in cytological diagnosis

A comparative study of the non-aspiration technique (FNC) with the conventional FNAC is reported in one hundred lesions at different sites. The former technique is based on the principle of capillary action. The sampling was assessed using 3 parameters. Cellular yield Cell architecture preservation Blood & clots in the background. In contrast to FNA sampling, FNC is simple, less traumatic with minimal blood in the background yielding superior quality material in 68% cases at a statistically significant rate. (p<0.01)

Improvement of the Mair scoring system using structural equations modeling for classifying the diagnostic adequacy of cytology material from thyroid lesions.

The scoring system developed by Mair et al. (Acta Cytol 1989;33:809-813) is frequently used to grade the quality of cytology smears. Using a one-factor analytic structural equations model, we demonstrate that the errors in measurement of the parameters used in the Mair scoring system are highly and significantly correlated. We recommend the use of either a multiplicative scoring system, using linear scores, or an additive scoring system, using exponential scores, to correct for the correlated errors. We suggest that the 0, 1, and 2 points used in the Mair scoring system be replaced by 1, 2, and 4, respectively. Using data on fine-needle biopsies of 200 thyroid lesions by both fine-needle aspiration (FNA) and fine-needle capillary sampling (FNC), we demonstrate that our modification of the Mair scoring system is more sensitive and more consistent with the structural equations model. Therefore, we recommend that the modified Mair scoring system be used for classifying the diagnostic adequacy of cytology smears. Diagn. Cytopathol. 1999;21:387-393.

Efficacy of Fine Needle Capillary Sampling in the Diagnosis of Stage III and IV Cervical Carcinoma

To test the sensitivity of fine needle capillary sampling (FNCS) as compared to scrape cytology in cervical carcinoma, stage III and IV, and to study the quality of material obtained by FNCS. Prospective. In 48 cases of cervical carcinoma, clinically stage III and IV, FNCS was done along with scrape cytology. The results were compared, considering histopathology as the gold standard. The quality of material obtained by both methods was compared using the parameters background, cellularity and cellular preservation. FNCS had a sensitivity of 87.5% as against 62.5% for scrape cytology. Material obtained by FNCS had a cleaner background and better cellularity and morphologic preservation. FNCS is superior to scrape cytology for the diagnosis of stage III and IV cervical carcinoma.

Evaluation of Fine Needle Capillary Sampling in Superficial and Deep-Seated Lesions

To study the efficacy and merits of a simplified cytologic technique of fine needle capillary (FNC) sampling in 670 cases. FNC sampling was tested on a consecutive series of 600 superficial palpable masses and 70 deep-seated lesions during the period January 1993-September 1993. Among superficial masses, sampling was done on 380 lymph nodes, 88 breast lesions, 56 thyroids, 12 salivary glands and 64 miscellaneous sites. Fifty-five lung lesions were sampled using 8 computed tomography, while 15 abdominal masses were sampled using ultrasonography. Cell samples were assessed as diagnostically adequate or inadequate. The diagnostic adequacy in lymph node, breast and thyroid lesions was 95%, 91.07% and 90.09%, respectively. The diagnostic adequacy for deep-seated lesions was 91.42%. The procedure gives a better perception of tumor consistency and control of the hand. FNC resulted in a high yield of good-quality material with retention of cellular architecture. It is recommended that the operator become familiar with the macroscopic slide appearance of a cellular smear. Doubts persist with respect to fibrotic and cystic lesions.