Diagnostic utility of fine needle aspiration cytology and core biopsy histopathology with or without immunohistochemical staining in the subtyping of the non‐small cell lung carcinomas: Experience from an academic centre in Turkey

Abstract

Introduction This retrospective morphological study compared the results of fine needle aspiration (FNA) cytology, haematoxylin‐eosin (HE)‐stained samples and immunohistochemical (IHC)‐stained core needle biopsy (CNB) histology samples for primary non‐small cell lung cancer (NSCLC) subtyping. We assessed the diagnostic utility of these methods to investigate the contribution of each method to NSCLC subtyping. We also identified the point at which NSCLC subtyping could be performed using histomorphology alone without IHC. Methodology Concurrent FNA and CNB specimens obtained via a single computed tomography‐guided procedure and diagnosed as NSCLC in the Pathology Department of our university within 3 years were reviewed. The results of FNA samples, HE‐stained biopsies and IHC‐stained biopsies were compared according to subtype. Results A total of 141 subjects were enrolled in the study. For subtyping, FNA provided an accurate diagnosis in 70 (55.1%) of 127 eligible subjects after the exclusion of 14 cases determined as not otherwise specified. CNB histology without IHC achieved a diagnosis in 53 (41.7%) of 127 subjects, which was a significant difference (P < .05). The compatibility rate between HE‐stained biopsy samples and IHC‐stained biopsy samples was 41.7% (53/127). Conclusion The diagnosis rates achieved using FNA, HE‐stained CNB samples and IHC‐stained CNB samples were 54.6% (77/141), 37.6% (53/141) and 90.1% (127/141), respectively. The subtype was identified in 55.1% of the subjects evaluated using FNA and 41.7% of subjects assessed using HE‐stained biopsy samples without IHC. FNA provided a better result for squamous cell carcinoma than adenocarcinoma (55.1% vs 47.6%), but the diagnosing of adenocarcinoma and squamous cell carcinoma using HE‐stained biopsy samples was similar (42% vs 41.7%).

Supplementary benefits of CT-guided transthoracic lung aspiration biopsy for core needle biopsy

“…Aspiration is the final chance to obtain suitable. Studies have shown that immunohistochemical analysis can be performed in cell wax samples ( Lozano et al, 2015 ; Bayrak et al, 2021 ). In this retrospective study, we found that the immunohistochemical analysis of aspirated cell wax had a significant supplementary effect on malignant tumors.…”

Utility of liquid‐based cytology on residual needle rinses collected from core needle biopsy for lung nodule diagnosis

“…14 Additionally, some institutions, especially in developing countries, lack sufficient facilities and cytologists specializing in rapid on-site evaluation compared with the institutions in developed countries. 15 Therefore, such institutions cannot perform CNBs with sensitivities similar to or higher than that of institutions in developed countries, although no statistical data have been reported. Touch preparations for rapid on-site evaluation of CNBs are also considered cytological diagnostic materials.…”

Technical aspects of the use of cytopathological specimens for diagnosis and predictive testing in malignant epithelial neoplasms of the lung

“…This provides optimum well‐preserved morphology. Papanicolaou is the stain of choice given the excellent nuclear morphology, and as it highlights keratinisation, it may be more specific in identifying keratinising squamous carcinoma than assessment of haematoxylin and eosin (H&E) CB or biopsy samples 62 . It is also acceptable to prepare direct slides from bronchial liquid samples such as washings or lavage samples.…”