Malignancy risk for the categories: Non‐diagnostic, benign, atypical, suspicious, and malignant used in the categorization of endobronchial ultrasound guided‐fine needle aspirates of pulmonary nodules

Abstract

The diagnostic categories are associated with increasing risk of malignancy running from non-diagnostic to malignant. The non-diagnostic category has a significant risk of malignancy. While the risk of malignancy for a benign diagnosis is substantial (24%), it is significantly less than that associated with an atypical or suspicious diagnosis. A suspicious diagnosis carries a risk for malignancy essentially the same as a malignant diagnosis. The categories atypical and suspicious appear to have substantially different risks for malignancy (54% vs.82%). The atypical category has twice the risk of malignancy as benign. This risk stratification may be useful for patient management.

The new guidelines of Papanicolaou Society of Cytopathology for respiratory specimens: Assessment of risk of malignancy and diagnostic yield in different cytological modalities

“…Nevertheless, until now there was no widely accepted categorization system for respiratory cytology, providing rational patient management in this setting. Therefore, the PSC has proposed new guidelines comprising a standardized classification of respiratory lesions with an associated risk of malignancy . In the current study, 1290 respiratory cytology cases were retrospectively reclassified in accordance with the new PSC guidelines and we analyzed the associated risks of malignancy for each category.…”

“…The use of multiple modalities of obtaining the diagnostic material had an effect in the assessment of ROM in the different diagnostic categories. On the contrary of previous studies that were mostly designed based on just one technique, EBUS‐FNA, our study evaluated different cytological specimens. Regarding the effect of the different sampling techniques on the results, in Table , the ROM was also analyzed for each category.…”

“…Therefore, the PSC has proposed new guidelines comprising a standardized classification of respiratory lesions with an associated risk of malignancy. 3,7 In the current study, 1290 respiratory cytology cases were retrospectively reclassified in accordance with the new PSC guidelines and we analyzed the associated risks of malignancy for each category. Our risk of malignancy for the ND category (64%) was higher than the implied ROM in PSC classification which is 40%.…”

“Atypical” salivary gland fine needle aspiration: Risk of malignancy and interinstitutional variability

“…Head and neck surgeons sometimes feel uncomfortable about the indeterminate diagnosis, and even doubt the value of FNA in accurately distinguishing benign and malignant salivary gland tumors . It has to be mentioned in this context that FNA diagnoses of other organ systems, including thyroid, pancreas, and lung, all include indeterminate categories . Clinical decisions after cytological indeterminate diagnoses in these organ systems are well established and well accepted by physicians of multiple disciplines.…”

Translational research: Empowering the role of pathologists and cytopathologists

“…It also has been demonstrated that rapid on‐site evaluation and molecular testing of cytologic specimens, such as endobronchial ultrasound‐guided fine‐needle aspiration specimens, are essential for clinical decision making in patients with lung cancer …”