Cytopathologist‐performed ultrasound‐guided fine‐needle aspiration and core‐needle biopsy: A prospective study of 500 consecutive cases

Lieu, M.B.A. David

doi:10.1002/dc.20800

Cited by 64 publications

(70 citation statements)

References 15 publications

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“…Sonographically guided thyroid nodule CB has been shown to be accurate, safe, and well tolerated (15,17,19,(26)(27)(28). There are several theoretical reasons why sonographically guided CB might be useful when thyroid nodule FNA is nondiagnostic: CB can provide more tissue than a nondiagnostic FNA and cellular architecture is retained, facilitating accurate histologic diagnosis (26,29,30).…”

Section: Discussionmentioning

confidence: 99%

“…Although core needle biopsies are widely used in other anatomic regions, relatively few series of US-guided core needle biopsy (CB) of thyroid nodules have been reported (16)(17)(18)(19)(20)(21). Current American Thyroid Association (ATA) thyroid Departments of 1 Radiology, 3 Pathology, 4 Surgery, and 6 Medicine; nodule management guidelines and the Society of Radiologists in Ultrasound Consensus Statement do not discuss the role of thyroid nodule core biopsy (CB) in the evaluation of thyroid nodules (8,12).…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Percutaneous Thyroid Nodule Core Biopsy: Clinical Utility in Patients with Prior Nondiagnostic Fine-Needle Aspirate

Samir

Vij

Seale

et al. 2012

Thyroid

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Background: Five percent to 20% of thyroid nodule fine-needle aspiration (FNA) samples are nondiagnostic. The objective of this study was to determine whether a combination of FNA and core biopsy (CFNACB) would yield a higher proportion of diagnostic readings compared with FNA alone in patients with a history of one or more prior nondiagnostic FNA readings. Methods: We conducted a retrospective study of 90 core biopsies (CBs) performed in 82 subjects (55 women and 27 men) between 2006 and 2008 in an outpatient clinic. Results: CFNACB yielded a diagnostic reading in 87%. The diagnostic reading yield of the CB component of CFNACB was significantly superior to the concurrent FNA component, with CB yielding a diagnosis in 77% of cases and FNA yielding a diagnosis in 47% ( p < 0.0001). The combination of CB and FNA had a higher diagnostic reading yield than either alone. In 69 nodules that had only one prior nondiagnostic FNA, CB was diagnostic in 74%, FNA was diagnostic in 52%, CFNACB was diagnostic in 87%, and CB performed significantly better than FNA ( p = 0.0135). In 21 nodules with two or more prior nondiagnostic FNAs, CFNACB and CB were diagnostic in 86%, FNA was diagnostic in 29%, and CB was significantly better than FNA ( p = 0.0005). Clinical, ultrasound, or histopathologic follow-up was available for 81% (73/90) of the CFNACB procedures. No subject with a benign CFNACB reading was diagnosed with thyroid malignancy in the follow-up period (range 4-37 months, mean 18 months), although one subject had minimal increase in nodule size and was awaiting repeat sonography at study conclusion. Conclusion: Thyroid nodule CFNACB is safe and clinically useful in selected patients when a prior FNA reading is nondiagnostic. CFNACB is superior to either CB or FNA alone. CFNACB should be strongly considered as an alternative to surgery in individuals with two prior nondiagnostic FNAs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Thyroid Nodule Core Biopsy: Clinical Utility in Patients with Prior Nondiagnostic Fine-Needle Aspirate

Samir

Vij

Seale

et al. 2012

Thyroid

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“…Addition of ultrasound guidance decreases the nondiagnostic rate for thyroid FNAs 105 and allows specific targeting toward solid or suspicious areas in heterogeneous nodules. 132 Nondiagnostic FNAs are a major source of increased cost to the health care system. 105,129 Perhaps the most important benefit of including ultrasound is that the ultrasound appearance itself can provide essential clues to the differential diagnosis.…”

Section: Value Of Addition Of Ultrasound Guidancementioning

confidence: 99%

“…Importantly, this strategy offers the patients the smallest, safest possible biopsy in as few clinic visits as possible. Rare cytopathologists are further extending their practice to the performance of core biopsies 132 and placement of radiologic clips when clinically indicated. 134 In one office visit, 87% of patients with breast masses were able to be diagnosed with only ultrasound-guided FNA; core biopsies were performed to enable diagnosis of invasion for patients with positive FNAs and to resolve nondiagnostic FNAs.…”

Section: Value Of Addition Of Ultrasound Guidancementioning

confidence: 99%

Five Top Stories in Cytopathology

Fischer,

Benedict,

Amrikachi

2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Cytology relies heavily on morphology to make diagnoses, and morphologic criteria have not changed much in recent years. The field is being shaped predominantly by new techniques for imaging and for acquiring and processing samples, advances in molecular diagnosis and therapeutics, and regulatory issues.Objective.-To review the importance of classical morphology in the future of cytopathology, to identify areas in which cytology is expanding or contracting in its scope, and to identify factors that are shaping the field.Data Sources.-Literature review.Conclusions.-Five stories paint a picture in which classical cytomorphology will continue to have essential importance, both for diagnosis and for improving our understanding of cancer biology. New endoscopy and imaging techniques are replacing surgical biopsies with cytology samples. New molecularly targeted therapies offer a chance for cytology to play a major role, but they pose new challenges. New molecular tests have the potential to synergize with, but not replace, morphologic interpretation of thyroid fine-needle aspirations. Ultrasound-guided fine-needle aspiration performed by cytopathologists is opening a new field of ''interventional cytopathology'' with unique value. For the productive evolution of the field, it will be important for cytopathologists to play an active role in clinical trials that document the ability of cytology to achieve cost-effective health care outcomes.(Arch Pathol Lab Med. 2013;137:894-906; doi: 10.5858/ arpa.2012-0258-SA) THE CONTINUING VALUE OF CYTOMORPHOLOGY C ytopathologists have been primarily morphologists, using the smallest possible biopsy specimen for diagnosis. It is unusual for new diagnostic morphologic features to be discovered. A rare example is the description of intranuclear cytoplasmic inclusions in at least a subset of pancreatic intraductal papillary mucinous neoplasms.1 The new Bethesda system for reporting thyroid cytopathology is certainly important, but the actual morphologic criteria for diagnosing thyroid fine-needle aspirations (FNAs) have scarcely changed in the past several decades. It seems that classical cytomorphology has brought the field about as far as it can go.Though new diagnostic cytomorphologies are not likely to help the productive evolution of cytology, the theme of this first story is that classical morphology will continue to have an essential value. In order to provide new useful clinical applications, cytopathology needs to be redefined as the field that uses the smallest possible biopsy specimen for diagnosis by using any technique. The full value of classical cytomorphology can be boosted by new technologies, including improvements in cell block techniques 2-4 and better microbiopsy needles. 5 The use of ultrasound guidance for cytopathologist-performed FNA and the development of new endoscopic techniques have provided new applications for classical cytomorphology. New immunofluorescent microscopy techniques are promising to synergize with classical cytomorphologic diagnosis...

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“…FNAC is a simple, safe, minimally invasive and fast technique that is well tolerated by patients. In addition, the single cell suspension that is suitable for FCM analysis is easy to prepare (16). FCM is a rapid and sensitive multi-parameter analysis technique, which is important in the diagnosis of patients with lymph node enlargement (17).…”

mentioning

confidence: 99%

Secondary B-cell lymphoma diagnosed by fine-needle aspiration cytology and flow cytometry following penile carcinoma: A case report

Wang

Qiu

et al. 2016

Oncology Letters

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Abstract.The number of studies reporting lymphoma as a secondary tumor has gradually increased. However, few studies have reported that occurrence of lymphoma as a secondary tumor following treatment for penile carcinoma, particularly cases in which the lymphoma was diagnosed by fine-needle aspiration cytology and flow cytometry. The present study reports the case of a 62-year-old male patient who was troubled with frequent urination and repeated chest tightness for 5 years. The diagnosis upon admission was penile carcinoma. Two months subsequent to the tumor removal surgery, enlarged lymph nodes were extracted from the patient using fine-needle biopsy, to be analyzed using light microscopy and flow cytometry. Smear results indicated a large number of abnormal cells scattered in the right axillary lymph node. Flow cytometry immunophenotyping of fine-needle aspiration samples indicated the increased expression of cluster of differentiation (CD)79a, CD19, CD20, CD38, κ chain and human leukocyte antigen-DR, which supported a diagnosis of B-cell lymphoma. Thus, the patient was diagnosed with B-cell lymphoma based on the results of the fine-needle aspiration biopsy and flow cytometry. The method of diagnosis and causes of therapy-related leukemia are discussed in the present report.

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Cytopathologist‐performed ultrasound‐guided fine‐needle aspiration and core‐needle biopsy: A prospective study of 500 consecutive cases

Cited by 64 publications

References 15 publications

Ultrasound-Guided Percutaneous Thyroid Nodule Core Biopsy: Clinical Utility in Patients with Prior Nondiagnostic Fine-Needle Aspirate

Ultrasound-Guided Percutaneous Thyroid Nodule Core Biopsy: Clinical Utility in Patients with Prior Nondiagnostic Fine-Needle Aspirate

Five Top Stories in Cytopathology

Secondary B-cell lymphoma diagnosed by fine-needle aspiration cytology and flow cytometry following penile carcinoma: A case report

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