Yield Of Fine Needle Aspiration Cytology Research Articles

A Study on Assessment of Diagnostic Yield of Cell Block, FNAC and Invasive Biopsy in Lung Mass with Effusion

BACKGROUND: Accurate diagnosis of histological subtype is of paramount importance in case of lung malignancy as it leads to variation in treatment and assessment of prognosis. Hence the current study was done to establish the yields of different diagnostic techniques to perform tests in institutes with lesser equipment. METHODS: prospective observational study performed in 45 patients who presented with pleural effusions with an underlying lung parenchymal mass in department of respiratory medicine, GEMS&H, Srikakulam, Andhra Pradesh from August 2021 to August 2022 were included in the current study. RESULTS: During the period of 12 months that is from August 2021 to August 2022 we came across 60 lung mass cases among them 45 presented along with pleural effusion. In them Cell block results were suggestive of malignant effusion in 13 out of 45 cases giving a yield of about 29% whereas the yield of FNAC (fine needle aspiration cytology) was 53% (24/45) giving a combined yield of 82% from cytological study. Biopsy was conclusive in all the cases with a yield of 100%. CONCLUSION: The combined yield of cell block and FNAC is high even though in the current study the efficacy of cell block and FNAC is lower to that of biopsy. Core needle biopsy is preferable to traditional cytology procedures, according to the current study, but in locations without the necessary equipment or when a patient is unfit for the treatment, the first line of inquiry should always be pleural fluid cell block and FNAC

Diagnostic Accuracy of Fine Needle Aspiration Cytology (FNAC) in Salivary Gland Lesions with Histopathological Examination (HPE) Correlation in a Tertiary Care Centre in Southern India.

This study aimed to determine the diagnostic yield of fine-needle aspiration cytology (FNAC) in salivary gland lesions compared to histopathological diagnosis. The present study was done on patients above 18years of age, with a palpable swelling, who are clinically diagnosed as salivary gland lesions were evaluated. A total of 31 patients were evaluated in this study. The mean age of the patients was 41years ± 16.08. The male to female ratio of patients evaluated in our study was 1: 1.066, with a marginal preponderance in the female population. There was a higher incidence of carcinoma in females than males. Parotid gland lesions comprised 83.9% of all the salivary gland lesions analyzed, while submandibular gland lesions comprised 16.1%. In our study, the distribution between non-neoplastic, neoplastic benign, and neoplastic malignant lesions was 9.6%, 83.8%, and 6.4%. The overall diagnostic accuracy for non-neoplastic and neoplastic lesions is 90.3%, with a sensitivity of 89% and a specificity of 100%. The segregation of the results into the positive and negative class of diagnostic outcomes shows 80.6% for true positive, 9.7% for true negative, 0% for false-positive, and 9.7% for false-negative reports. Diagnostic accuracy in differentiating non-neoplastic and neoplastic lesions is 90.3%, with a sensitivity and specificity of 89.0% and 100%, respectively. The diagnostic accuracy of FNAC in differentiating benign from malignant lesions in our study is 93.5% (29 out of 31), the sensitivity of FNAC in our study for diagnosing malignancy is poor, and the specificity is 100%. It can be concluded that FNAC is more accurate in diagnosing benign lesions and more specific than sensitive in diagnosing malignant lesions.

Ultrasound-guided lymph node sampling: accuracy of FNAC, end-cutting (Franseen), and side-cutting (Temno) needle biopsy techniques

To compare technical success, diagnostic accuracy, and histological yield of fine-needle aspiration cytology (FNAC), side-cutting (Temno) needle biopsy, and end-cutting (Franseen) needle biopsy for ultrasound-guided sampling of groin and axillary lymph nodes. A total of 270 abnormal groin and axillary nodes were sampled using one of the three techniques. Nodes with a maximum length of <2.5cm underwent FNAC or Franseen biopsy, while nodes >2.5cm underwent Temno biopsy. Mean size of nodes sampled by FNAC (21.2mm) and Franseen (19.7mm) were similar while nodes sampled by Temno were larger (34.4mm, p<0.0001). Technical success rates of FNAC (82/93, 88%), Franseen (105/111, 95%), and Temno (59/66, 89%) biopsies were similar (p>0.05 for all). Lymphoid tissue yield by FNAC (mean total area 1.51mm2) was less than that by Franseen (7.14mm2, p=0.002) or Temno biopsy (19.44mm2, p<0.0001). Diagnostic accuracy for malignancy was lower for FNAC (22/30, 73%) than Franseen (25/26, 96%, p=0.02) or Temno biopsy (32/32, 100%, p=0.002). For malignant nodes, determining the likely organ of origin was also lower for FNAC (7/30, 23%) than Franseen (19/26, 73%, p=0.0002) or Temno biopsy (29/32, 91%, p<0.0001), with a similar pattern observed in the identification of lymphoma. For similarly sized nodes, Franseen biopsy provided more lymphoid material, a higher diagnostic accuracy for malignancy including lymphoma, and better identification of the likely organ of origin than FNAC. Routine use of Franseen biopsy is advocated rather than FNAC for percutaneous sampling of lymph nodes not suitable for side-cutting needle biopsy.

Usage and Diagnostic Yield of Fine-Needle Aspiration Cytology and Core Needle Biopsy in Thyroid Nodules: A Systematic Review and Meta-Analysis of Literature Published by Korean Authors.

ObjectivesThe usefulness of core needle biopsy (CNB) for the diagnosis of thyroid nodules remains controversial, and preferences vary across hospitals. The purpose of this study was to assess the actual use of CNB in Korea and to analyze the advantages and disadvantages of CNB through a systematic review and meta-analysis of papers published by Korean authors.MethodsA meta-analysis of full-text publications published in English presenting data from Korea retrieved from the Embase literature database was performed.ResultsCNB led to a significantly lower proportion of non-diagnostic results than fine-needle aspiration (FNA). However, the frequency of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) did not decrease as a result of performing CNB in nodules with initial AUS/FLUS results, while it increased in consecutive cases. A subcategory analysis of AUS/FLUS showed that the increased frequency of AUS/FLUS findings on CNB was due to more frequent diagnoses of architectural atypia and follicular neoplasm, which resulted in a higher frequency of inconclusive findings in consecutive cases compared to FNA. Hospitals favoring CNB had a higher proportion of AUS/FLUS diagnoses. Although the complication rate did not differ significantly between CNB and FNA, serious complications of CNB did occur.ConclusionA reduced frequency of non-diagnostic results may be a definite advantage of CNB over FNA. However, the increased frequency of diagnoses of architectural atypia and follicular neoplasm should be considered when selecting CNB as a diagnostic tool.

Influence of the Histopathological Features of the Lesion on the Diagnostic Yield of Fine-Needle Aspiration Cytology of Pancreatic Solid Lesions

Objective: The rate of pancreatic lesions has increased in recent decades due to the widespread use of advanced imaging techniques. Nowadays, a significant proportion of cases are incidentally discovered in asymptomatic patients and cytology is an important tool for the diagnosis and multidisciplinary management of these cases. Study Design: In this study we retrospectively review the experience with pancreatic fine-needle aspiration cytology in the last 17 years at a single large tertiary hospital in Madrid, Spain. Results: Our results indicate that more than 60% of pancreatic malignant lesions are cytologically confirmed before surgery and 30% of the patients are asymptomatic. Despite this, we have noted that the total number of malignant lesions surgically resected in our hospital has basically remained unchanged over the years, because incidental diagnosis is not always synonymous with resectability and a substantial number of patients are already metastatic at the time of diagnosis. Our series also shows an increase in the number of neuroendocrine tumors, which now represent almost 20% of all cytological diagnoses at our hospital. The sensitivity in our series is 70% and the false negative rate remains 30%, despite sample quality control by experienced cytologists and standardized technical conditions. Fibrosis and necrosis are the 2 features of the primary tumor that significantly and negatively influence the accuracy of cytologic diagnosis. Conclusion: We herein report our experience with cytologic diagnosis of pancreatic lesions in a single tertiary hospital. Our results confirm that cytology is a safe, reliable, and important tool for pancreatic lesion diagnosis and management.

The size of thyroid nodules contributing to the diagnostic efficiency of repeat fine needle aspiration cytology

Objective To evaluate the association of the size of thyroid nodules and the diagnostic value of repeat fine needle aspiration cytology(FNAC) in diagnose of thyroid nodules. Methods One hundred and forty-three thyroid nodules in one hundred and thirty-five patients with repeat FNAC and thyroidectomy were retrospectively analyzed. The nodules were divided into three groups according to the largest diameter(L) : Group A, L 1.0 cm. Yield of FNACs were divided into six levels according to the classification criteria of the Bethesda system, and Level Ⅰ, Ⅲ, Ⅳ, Ⅴ were defined as the indefinite cytological diagnosis. Results The diagnostic rate of repeat FNAC was obviously higher in group B compared with group A and group C, with significantly statistical difference (P 0.05). The diagnostic accuracy of repeat FNAC in group B was significantly higher than that in group A(P<0.05), but not in group C (P<0.05). Conclusions The repeat FNAC has a higher efficiency in those nodules with a largest diameter between 0.5 cm and 1.0 cm, and a repeat FNAC can be suggested. Key words: Ultrasonography; Thyroid nodule; Biopsy, fine needle

Diagnostic yield of fine-needle aspiration cytology in HIV-infected patients with lymphadenopathy in the era of highly active antiretroviral therapy

Fine-needle aspiration (FNA) cytology has an established role in the investigation of lymphadenopathy in HIV-infected patients. However, changes in the spectrum of disease have been observed since the introduction of highly active antiretroviral therapy (HAART). The aim of the study was to establish whether FNA cytology remains a useful investigative tool in the post-HAART era and to determine whether the cytology results reflect the changing patterns of disease. Retrospective search of the cytopathology database at University College London Hospitals identified 73 FNA cytology procedures performed in 62 patients between January 1998 and December 2006. FNA cytology showed significant disease in 90% of adequate samples. The most common diagnoses were persistent generalized lymphadenopathy (PGL, 50%), infection (22%) and malignancy (18%). Diagnoses could not be made in 31% of patients because of inadequate sampling. An open lymph node biopsy was subsequently performed in 27% of patients. FNA cytology remains an important initial investigation in the post-HAART era, particularly in the diagnosis of PGL, infection and malignancy. Difficulties in diagnosis of Castleman disease and Hodgkin's lymphoma by FNA cytology are recognized.