Role of rapid on-site evaluation with cyto-histopathological correlation in diagnosis of lung lesion

Abstract

Aim:This study was conducted to assess the role of cytology in the diagnosis of lung lesions and to compare it with histopathology. It was also intended to evaluate the role of rapid on site evaluation (ROSE) as an adjunct to cytological diagnosis of lung lesions.Materials and Methods:The study included all the cases of lung lesions, which were diagnosed on cytology followed by histopathology over a period of 2½ years along with ROSE, wherever possible.Results:Cytology was done in total 782 cases of various lung lesions and of this cyto-histopathological correlation was available in 215 cases. ROSE was done in 93.4% of total cases and smears were considered on the site adequate in the first pass in 68.1% cases and in second pass adequacy increased to 93.4%. The diagnostic accuracy of cytology was 75.3%, and that of histology was 86.9% in the diagnosis of lung lesions. The diagnostic accuracy of cytology for squamous cell carcinoma (94.4%) and adenocarcinoma (96.5%) was higher than that of histology.Conclusion:Cytology is comparable to histology in the diagnosis of lung lesions and may even outperform biopsy in lung tumor diagnosis. The advantages of cytology may be further added by better sampling and preanalytical assessment for adequate diagnostic material and ROSE has proved to be an important, easy and cost effective adjunct in this regard. A multidisciplinary approach involving pulmonologist, radiologist and cytopathologist with ROSE, followed by vigilant morphological examination may increase diagnostic utility of cytology for lung lesions.

Hepatic fine-needle aspiration cytology: The role of rapid on-site evaluation in the assessment of hepatic lesions

“…This was a limitation of our study. Final cytodiagnosis was given only after the evaluation of MGG, H&E, and Papanicolaou smears, similar to that in the study conducted by Chandra et al (15). Other disadvantages associated with the use of ROSE are prolonged time for each FNAC and increased cost of using a pathologist as well as a radiologist for the same procedure (1).…”

“…The role of ROSE has been explored in the endoscopic-guided FNAC of thyroid lesions, pancreatic masses, TBNA of mediastinal and lymph nodal masses, and lung cytology, while we have studied the impact of ROSE on yield of ultrasound-guided FNACs of hepatic lesions (2,8,9,11,(13)(14)(15).…”

Study of the Pre-Analytical Phase of an ISO 15189: 2012-Certified Cytopathology Laboratory: A 5-Year Institutional Experience

“…It not only requires the technical skill of the aspirator, but also ROSE to check the adequacy of the material aspirated instantaneously. It was observed through a previous study in our lab that adequacy in lung lesions increased from 68.1 to 98.3% by utilizing the easy and cost-effective method of ROSE [12]. Another important aspect of the pre-analytical phase of quality management in the cytopathology lab is that the prepared smears should not be thick and bloody so that the cytomorphological features are not obscured.…”

Review of different platforms to perform rapid onsite evaluation via telecytology

“…The utilisation of rapid onsite evaluation (ROSE) of fine needle aspiration (FNA) biopsy and core needle biopsy continues to increase due to growth of minimally invasive biopsy procedures such as endobronchial ultrasound-guided FNA, computed tomography-guided FNA, and endoscopic ultrasound-guided FNA. [1][2][3] The growth is likely to be sustained in the future given the growing reliance on FNA as a relatively less invasive method for obtaining tissue materials for diagnosis and ancillary studies. ROSE can simultaneously increase the quality of FNA to support these goals and decrease the overall procedural cost by reducing the rate of non-diagnostic FNAs, repeat FNAs, and excess needle passes through real-time feedback on the quality of the collected tissue materials.…”