Diagnostic utility of cell block in fine needle aspiration cytology of thyroid gland

Vance, Jesse; Durbin, Karen; Manglik, Niti; Gilani, Syed M.

doi:10.1002/dc.24304

Cited by 8 publications

(4 citation statements)

References 20 publications

(26 reference statements)

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“…In one study, the use of CB in addition to the cytology method has been shown to reduce the non-diagnostic category rate by 7.1% compared to cytological examination without a CB. [25] In another study, consistent with the findings obtained in this study, CB examination has been shown to reduce the non-diagnostic category rate. [26] The increase of sensitivity and specificity of the additional CB that we emphasize has also been reported in a study.…”

Section: Discussionsupporting

confidence: 87%

Evaluation of thyroid fine needle aspiration biopsies according to cytological methods and comparison with histopathological diagnoses

et al. 2020

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F ine-needle aspiration biopsy (FNAB) examination of thyroid nodules is performed routinely as a preferred method concerning cytological high sensitivity and spec-ificity, which is easy to apply in practice, without severe complications. [1][2][3][4] Cytological diagnosis standardization has advanced with the widespread use of the Bethesda Objectives: In this study, we aim to compare the results of aspiration of thyroid nodules evaluated according to the Bethesda category (BC) with tissue diagnoses in the operation materials and to compare the sensitivity, specificity and accuracy rates according to cytology methods. Methods: The previous fine-needle aspiration biopsy (FNAB) of thyroid nodules of 879 cases diagnosed histopathologically between 2010 and 2017 was examined. The FNAB results determined according to the Bethesda system were matched with tissue diagnoses, sensitivity, specificity, and accuracy rates were investigated according to cytology methods. Results: Sensitivity, specificity, Positive predictive value (PPV), Negative predictive value (NPV) and accuracy rates were found in all FNAB results (in units of %; Sensitivity; 84.7, Specificity; 81.1, PPV; 74.1, NPV; 89.2, Accuracy; 82.5). All of the cytological evaluation methods of thyroid FNABs were found to be reliable and effective (Generally, the results are 80% and above). Specificity and accuracy rates were close to the general average (82.5%) in all methods. However, in cases evaluated with liquid base cytology (LBC) method and in addition to LBC or conventional smear (CS), the sensitivity rates in cases where cell block (CB) were evaluated together were higher than cases in which LBC and CS were used alone (92.6% and 91.0%). When examined statistically, there was no significant difference concerning sensitivity, specificity and accuracy rates of cytological methods (p>0. 05, respectively, p=0.576, 0.065, 0.643). Conclusion:In cytopathology, when evaluating thyroid aspirations, it is seen that the LBC method is used instead of CS. In our study, we recommend the use of the LBC method, which seems to have the highest sensitivity (taking into account its technical advantages), instead of CS. However, we think that both CS and LBC methods should be evaluated by supporting them with cell block sections.

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Section: Discussionsupporting

confidence: 87%

Evaluation of thyroid fine needle aspiration biopsies according to cytological methods and comparison with histopathological diagnoses

et al. 2020

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“…This percentage of non-diagnostic cases could potentially be reduced by using cell block specimens on the FNA material. However, this is not a routine procedure, the rate of non-diagnostic results could be slightly reduced ( 31 ), and, although commonly applied in our center in lung and liver lesions, it is not performed on thyroid nodules.…”

Section: Discussionmentioning

confidence: 99%

Core Needle Biopsy Can Early and Precisely Identify Large Thyroid Masses

et al. 2022

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BackgroundLarge thyroid masses, particularly if rapidly growing, are often characterized by compression and infiltration of the vital structures of the neck. Therefore, an early and precise diagnosis, not only of malignancy but also of histotype, is mandatory to set up the right therapy. The aim of this study was to evaluate the diagnostic performance of fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) in this setting.Patients and MethodsWe prospectively evaluated 95 patients with large and rapidly growing thyroid masses admitted to the University Hospital of Pisa between April 2014 and January 2020. All patients were submitted to FNAC and CNB in the same session. The ability of both procedures to diagnose the malignancy of the lesions, particularly the histotype, and to obtain sufficient material to perform molecular analysis was evaluated.ResultsFNAC obtained adequate tumor sample to reach a diagnosis in 76 of 95 (80%) patients, while a higher percentage was obtained with CNB (92/95, 96.8%). FNAC was able to identify the malignancy of the lesion in 74 of 95 (77.9%) cases, but only in 16 of 74 (21.6%) cases was it able to define the histotype. CNB was able to define the malignancy of the lesion in all but three cases (92/95, 96.8%), and in all specimens, the histotype was identified. Moreover, in all cases, the material extracted from CNB was optimal to perform molecular analysis. No surgery-related complications were experienced with both procedures.ConclusionsCNB is a rapid and safe procedure with higher performance compared to FNAC in identifying the histotype of large and rapidly growing thyroid masses. Moreover, adequate material can be obtained to characterize the molecular profile for the treatment of potentially lethal cancers. In the era of precision medicine, CNB should be introduced in routine clinical practice as a key procedure for an early diagnosis and therapy of these diseases.

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“…The incorporation of rapid on‐site evaluation (ROSE) further enhances its utility by gauging sample adequacy, leading to a notable decrease of approximately 20% in inadequate rates 4,13 . The precision of FNAC's diagnostic outcomes is augmented through immunocytochemistry (ICC) on diverse substrates such as cell block (CB), liquid‐based cytology (LBC) or smears, along with molecular testing, 14–17 and flow cytometry (FC) for lymphoproliferative processes 6,10,18–24 …”

Section: Introductionmentioning

confidence: 99%

“…4,13 The precision of FNAC's diagnostic outcomes is augmented through immunocytochemistry (ICC) on diverse substrates such as cell block (CB), liquid-based cytology (LBC) or smears, along with molecular testing, [14][15][16][17] and flow cytometry (FC) for lymphoproliferative processes. 6,10,[18][19][20][21][22][23][24] Nonetheless, despite the documented high sensitivity and specificity values, 2,4,25 FNAC may prove insufficient to reach actionable diagnoses in certain pathologies, particularly those necessitating extensive immunohistochemical panels and molecular testing, or intricate cases wherein histological architectural features are pivotal for diagnosis. 5,20 Core needle biopsy (CNB) emerges as a potent sampling technique offering the advantage of revealing tissue architecture and obtaining samples more substantial than those garnered via FNAC and CB.…”

Section: Introductionmentioning

confidence: 99%

Combined fine needle aspiration cytology and core needle biopsy in the same setting: A two‐years’ experience

Ciliberti,

Maffei,

D'Ardia

et al. 2023

Cytopathology

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IntroductionFine needle aspiration cytology (FNAC) combined with rapid on‐site evaluation (ROSE) and ancillary techniques is an accurate diagnostic tool for many pathologies. However, in some cases, it may not be sufficient for actionable diagnoses or molecular testing, especially for cases that require large immunohistochemical panels or cases in which histological features are mandatory for the diagnosis. Core needle biopsy (CNB), on the contrary, provides samples that are suitable for histological features and sufficient for all ancillary studies. However, CNB is often performed by radiologists or clinicians without the direct participation of cytopathologists, which can lead to missed or delayed diagnoses. This study reports on the experience of combining FNAC and CNB performed in one setting by cytopathologists. The aim was to evaluate the impact of CNB on FNAC and the diagnostic efficiency of the combined procedures.Materials and MethodsOne hundred forty‐two FNAC and CNB procedures performed in the same setting over a period of 2 years were analysed. The FNAC diagnoses were compared and integrated with the subsequent CNB diagnoses. The impact of CNB was categorized as follows: non‐contributory, in cases of inadequate samples; confirmed, when the CNB and FNAC diagnoses were the same; improved, when the CNB diagnosis was consistent with the FNAC diagnosis and further specified the corresponding entity; allowed, when CNB produced a diagnosis that could not be reached by FNAC; changed, when the CNB changed the previous FNAC diagnosis.ResultsCNB confirmed the FNAC diagnosis in 40.1% of cases (n = 57/142). CNB improved the FNAC diagnosis in 47.2% of cases (n = 67/142). CNB allowed a diagnosis that could not be performed on FNAC in 2.1% of cases (n = 3/142). CNB changed a previous FNAC diagnosis in 2.1% of cases (n = 3/142). CNB was non‐contributory in 8.4% of cases (n = 12/142). CNB produced a positive impact on the whole diagnostic procedure in 51.4% of total cases (n = 73/142). The combined FNAC and CNB resulted in actionable diagnoses in 91.5% of all cases (n = 130/142). A complete molecular assessment was successfully performed in 14.7% of cases (n = 21/142) utilizing either FNAC or CNB material.ConclusionsThe combined use of FNAC and CNB in one setting improves the diagnostic accuracy of both procedures. This approach exploits the advantages of each procedure, enhancing the accuracy of the final diagnosis.

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Diagnostic utility of cell block in fine needle aspiration cytology of thyroid gland

Cited by 8 publications

References 20 publications

Evaluation of thyroid fine needle aspiration biopsies according to cytological methods and comparison with histopathological diagnoses

Evaluation of thyroid fine needle aspiration biopsies according to cytological methods and comparison with histopathological diagnoses

Core Needle Biopsy Can Early and Precisely Identify Large Thyroid Masses

Combined fine needle aspiration cytology and core needle biopsy in the same setting: A two‐years’ experience

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