Impact of touch preparations on core needle biopsies

Tong, Leung Chu; Rudomina, Dorota; Rekhtman, Natasha; Lin, Oscar

doi:10.1002/cncy.21447

Cited by 25 publications

(27 citation statements)

References 5 publications

(7 reference statements)

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“…In cases with very limited tissue, a portion of a slide (ie, touch prep, smear, or ThinPrep) can be sacrificed for molecular testing without all diagnostic material from a case being compromised. This is not otherwise possible because Clinical Laboratory Improvement Amendments regulations mandate storing slides for 10 years . In some situations, uniting the preparations may not be ideal.…”

Section: Discussionmentioning

confidence: 99%

FNA, core biopsy, or both for the diagnosis of lung carcinoma: Obtaining sufficient tissue for a specific diagnosis and molecular testing

Coley

Crapanzano

Saqi

2015

Cancer Cytopathology

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BACKGROUND Increasingly, minimally invasive procedures are performed to assess lung lesions and stage lung carcinomas. In cases of advanced‐stage lung cancer, the biopsy may provide the only diagnostic tissue. The aim of this study was to determine which method—fine‐needle aspiration (FNA), core biopsy (CBx), or both (B)—is optimal for providing sufficient tissue for rendering a specific diagnosis and pursuing molecular studies for guiding tumor‐specific treatment. METHODS A search was performed for computed tomography–guided lung FNA, CBx, or B cases with rapid onsite evaluation. Carcinomas were assessed for the adequacy to render a specific diagnosis; this was defined as enough refinement to subtype a primary carcinoma or to assess a metastatic origin morphologically and/or immunohistochemically. In cases of primary lung adenocarcinoma, the capability of each modality to yield sufficient tissue for molecular studies (epidermal growth factor receptor, KRAS, or anaplastic lymphoma kinase) was also assessed. RESULTS There were 210 cases, and 134 represented neoplasms, including 115 carcinomas. For carcinomas, a specific diagnosis was reached in 89% of FNA cases (33 of 37), 98% of CBx cases (43 of 44), and 100% of B cases (34 of 34). For primary lung adenocarcinomas, adequate tissue remained to perform molecular studies in 94% of FNA cases (16 of 17), 100% of CBx cases (19 of 19), and 86% of B cases (19 of 22). No statistical difference was found among the modalities for either reaching a specific diagnosis (p = .07, Fisher exact test) or providing sufficient tissue for molecular studies (p = .30, Fisher exact test). CONCLUSIONS The results suggest that FNA, CBx, and B are comparable for arriving at a specific diagnosis and having sufficient tissue for molecular studies: they specifically attained the diagnostic and prognostic goals of minimally invasive procedures for lung carcinoma. Cancer (Cancer Cytopathol) 2015;123:318–26. © 2015 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

FNA, core biopsy, or both for the diagnosis of lung carcinoma: Obtaining sufficient tissue for a specific diagnosis and molecular testing

Coley

Crapanzano

Saqi

2015

Cancer Cytopathology

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“…In addition, we encountered instances, albeit uncommon, in which cellular TPs were associated with minimal or no residual tumor cells in the residual CNBs. This was documented in a recent study 19 from our institution, in which a review of 1100 consecutive CT-guided CNBs revealed that in 15 cases (1.4%), CNBs were substantially or completely depleted (0-20 tumor cells remaining in CNB) as a result of TPs. In another recent clinical series, it was reported that of 140 CT-guided CNBs, tumor exhaustion as a result of TPs occured in 9 (8.2%) of cases.…”

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confidence: 59%

“…These findings model our observations from clinical practice, in which some TPs resulted in marked or complete depletion of CNB cellularity-an issue that has only recently come to attention in the literature. 19,20 Our finding regarding the risk of CNB depletion from TPs must be viewed in the context of the overall clinical benefit of this practice. The practice of performing TPs on CTguided CNBs is relatively new, and to our knowledge, no formal study has evaluated the overall clinical benefit of its routine use relative to CNBs with no on-site assessment or with more traditional on-site assessment performed on concurrent FNA.…”

Section: Commentmentioning

confidence: 99%

“…Second, all CNBs in this study were procured with an 18-gauge needle, whereas other needle sizes are employed in clinical practice and may have different propensity for depletion by TPs, as suggested in our clinical study where smaller-gauge CNBs were associated with more-frequent depletion. 19 Third, in this study, we modeled an idealized diagnostic assessment, because CNBs were derived from clear areas of tumor or benign tissue. Clinical CNBs, in contrast, may sample the edge of a tumor and/or contain benign tissue picked up en route to the lesion and can, therefore, contain a mixture of neoplastic and nonneoplastic elements, making the interpretation of corresponding TPs more difficult.…”

Section: Commentmentioning

confidence: 99%

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Depletion of Core Needle Biopsy Cellularity and DNA Content as a Result of Vigorous Touch Preparations

Rekhtman¹,

Kazi²,

Yao³

et al. 2014

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Touch preparations (TP) of core needle biopsies (CNBs) are used at some institutions for on-site assessment of CNB adequacy. In our clinical practice, we have encountered instances in which TPs resulted in substantial depletion of CNB cellularity.Objective.-To examine the effect of increasingly vigorous TPs on cellularity and DNA content of CNBs.Design.-Ex vivo CNBs (n ¼ 56) were performed on resected lung and kidney tumor specimens. For each specimen, CNBs were performed in quadruplicate on tumor and nontumor tissue and subjected to 1 of 4 TP methods: imprint, 1-cm drag, 2-cm drag, or full-slide drag. Overall cellularity in TPs relative to corresponding CNBs was estimated semiquantitatively. DNA was extracted and quantified from 12 TPs and corresponding CNBs. Two cytopathologists performed a blinded diagnostic assessment of Diff-Quik-stained TPs.Results.-Cellularity of imprint, 1-cm, 2-cm, and fullslide TPs represented, on average, 19%, 33%, 41%, and 46% of total CNB cellularity, respectively (P ¼ .003). Average DNA content in imprint, 1-cm, and 2-cm TPs was 0.3 lg (range, 0.1-0.8 lg), 0.4 lg (range, 0.1-1 lg), and 0.6 lg (range, 0.2-1.3 lg), respectively, which represented on average 15%, 36%, and 50%, respectively, of total CNB DNA content. Diagnostic accuracy was not inferior for less-extensive TPs, compared with more-extensive TPs.Conclusions.-Vigorous TPs may contain a substantial fraction of CNB cellularity and DNA content, whereas more-limited TPs are less disruptive to CNBs but remain suitable for cytologic assessment. We suggest avoiding excessively forceful TPs and, whenever clinically feasible, obtaining additional samples to ensure sufficient cellularity for potential ancillary studies.

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“…Cytologic evaluation of a tissue CNB can be accomplished by examining touch preparation slides. However, in this zero‐sum game transfer of cellular material from the core to the cytology‐evaluated slide can significantly decrease the cellularity of the remaining core biopsy, which is especially true for touch preparations of CNBs of the lung …”

Section: Introductionmentioning

confidence: 99%

Fine‐needle aspiration and core needle biopsy: An update on 2 common minimally invasive tissue sampling modalities

VanderLaan

2016

Cancer Cytopathology

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Fine-needle aspiration (FNA) and core needle biopsy (CNB) represent 2 of the most common minimally invasive tissue sampling modalities. Although similar in many ways, there are significant differences in the collection, processing, interpretation, and suitability for ancillary testing that exist between FNA and CNB. This review provides a brief overview of the strengths and weaknesses of FNA compared with CNB, as well as an update regarding the landscape of recently published studies that investigate the organ-specific comparative performance metrics of FNA and CNB. A current understanding of the benefits and limitations of FNA and CNB will help the cytopathologist and the clinician alike to select the right procedure for the right patient at the right time. Cancer Cytopathol 2016;124:862-870. © 2016 American Cancer Society.

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Impact of touch preparations on core needle biopsies

Cited by 25 publications

References 5 publications

FNA, core biopsy, or both for the diagnosis of lung carcinoma: Obtaining sufficient tissue for a specific diagnosis and molecular testing

FNA, core biopsy, or both for the diagnosis of lung carcinoma: Obtaining sufficient tissue for a specific diagnosis and molecular testing

Depletion of Core Needle Biopsy Cellularity and DNA Content as a Result of Vigorous Touch Preparations

Fine‐needle aspiration and core needle biopsy: An update on 2 common minimally invasive tissue sampling modalities

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