Systematized protocol for interventional pathology reports. Pathology report paradigm for pathologist-performed Ultrasound Guided Fine Needle Aspiration (USFNA) and Ultrasound Guided Core Needle Biopsy (USCNB)

Zarra, Karen Villar; Rivas, Héctor Enrique Torres; Rollins, Susan D.; Fernández, Luis Manuel Fernández; Llanos, Santiago Nieto

doi:10.1016/j.patol.2019.01.008

Cited by 5 publications

(3 citation statements)

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“…The primary element of this step is integrating the information. In 2019, we published a protocol [26] that, like the Sydney system, establishes a guide of items to be included in the report. If the interventional pathologist oversees systematizing and performing the entire USFNA diagnostic process [6], then the pathology report is likely to cover all the recommendations -essential suggestions and more [1].…”

Section: Discussionmentioning

confidence: 99%

“…Three pathologists with ultrasound-guided interventional training alternated performing the diagnostic procedure and were accompanied by a cytotechnologist and, occasionally, a pathology resident. In the interventional consultation of the pathology department, the following systematic approach was used for the care of patients with superficial lymphadenopathy (palpable or not) [26]: 1. Identification of the patient and confirmation of the request for a cytological examination of the lymphadenopathy.…”

Section: Methodsmentioning

confidence: 99%

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Ultrasound-Guided Fine-Needle Aspiration of Superficial Lymphadenopathy Performed by Interventional Pathologists: The Applicability of the Sydney System from 2 Years of Experience and 363 Cases

et al. 2021

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Introduction: The Sydney system proposal for the study and reporting of lymphadenopathy by fine-needle aspiration (FNA) constitutes one of the first attempts to standardize this procedure. Here, we review its applicability. Materials and Methods: A retrospective study in which all ultrasound-guided FNAs (USFNAs) of superficial lymphadenopathy (palpable or not) performed by interventional pathologists in 2 specialized hospital centers were quantified over 2 years. The procedure was systematized, and the diagnoses were reclassified according to the Sydney system categories. Results: We analyzed 363 USFNAs of lymphadenopathies. The distribution of cases by categories was as follows: insufficient (n = 13; 3.58%), benign (n = 208; 57.30%), atypia of uncertain significance (n = 7; 1.93%), suspicious (n = 21; 5.79), and malignant (n = 114; 31.40%). The risks of malignancy calculated for categories I, II, III, IV, and V were 27%, 3%, 50%, 100%, and 100%, respectively. Conclusion: The implementation of the Sydney system allows the systematization and standardization of the lymph node FNA methodology, with increased efficacy and efficiency. Assimilating the recommendations enables the qualification of the diagnostic procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Ultrasound-Guided Fine-Needle Aspiration of Superficial Lymphadenopathy Performed by Interventional Pathologists: The Applicability of the Sydney System from 2 Years of Experience and 363 Cases

et al. 2021

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“…Moreover, ROSE can confirm the validity of the samples. We used this approach in our patient, which facilitated real‐time decision‐making to enable acquisition of appropriate samples 13 ; in this patient, we could correctly select a needle of optimal length and gauge, limit the number of passes to two, prepare cytological smears on pretreated slides, and use a part of the sample for cell block preparation. Based on the detection of amyloid deposits on histopathological evaluation, it was reasonable to consider the possibility of medullary thyroid carcinoma in this patient; however, the cytomorphological findings that characterize this tumor were absent, and we excluded this diagnosis 3 .…”

Section: Discussionmentioning

confidence: 99%

Amyloid goiter diagnosis by ultrasound‐guided fine needle aspiration performed by interventional pathologist

Celis-Pinto

Rivas

Fernández

et al. 2020

Diagnostic Cytopathology

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Amyloid goiter (AG) (primary or secondary) is extremely rare. An abdominal fat pad core needle biopsy (CNB) is the diagnostic gold standard for secondary amyloidosis. Although CNB is useful to detect amyloid infiltration of a specific organ, fine‐needle aspiration (FNA) is proven to be the best diagnostic method for thyroid disorders. Guidelines recommend an ultrasound‐guided FNA (US‐FNA) whenever possible. This procedure is usually performed by various interventional specialists, including pathologists, who perform the procedure in addition to validating the adequacy of the sample. We report a rare case of AG diagnosed using US‐FNA performed by a pathologist in a 39‐year‐old patient with systemic amyloidosis. US‐FNA performed by pathologists is a proven, less‐invasive, and cost‐effective tool that ensures acquisition of adequate specimens and reduces nondiagnostic rates of this procedure to ensure timely cytological diagnosis.

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Resident training in interventional pathology: Ultrasound‐guided fine‐needle aspiration and rapid on site evaluation—5 years of teaching experience in a single university hospital

Torres‐Rivas,

Fernández Fernández,

González Gutiérrez

et al. 2024

Cytopathology

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IntroductionDespite the established role of the interventional pathologist, their diagnostic performance is difficult to establish. At least in Spain training of pathology residents in ultrasound‐guided interventional procedures for specimen collection is limited or absent in most institutions. We present our teaching experience in the instruction of ultrasound‐guided fine‐needle aspiration (FNA) to pathology residents in a tertiary‐level hospital.Materials and MethodsThe training of pathology residents who rotated through the interventional unit of the pathology department and the application of ultrasound‐guided FNA and rapid on‐site evaluation (U‐ROSE) was documented over 5 years. The training period was broken down into learning phases and included the number of ultrasound‐guided FNA performed, anatomical location, and their diagnostic performance, among other aspects.ResultsNineteen (19) pathology residents were trained in U‐ROSE, and performed a total of 4003 procedures, with a mean of 211 per resident. In 53% of cases only one pass was required for an adequated sample. The specimen was diagnostic in more than 97% of cases. The most frequently sampled anatomical sites were the thyroid gland (n = 2347), followed by lymph node (n = 667), soft tissues (n = 663) and salivary glands (n = 322).ConclusionThe results support the training programme followed by pathology residents in learning U‐ROSE, which is essential to lay the foundations for the future interventional pathologist.

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Systematized protocol for interventional pathology reports. Pathology report paradigm for pathologist-performed Ultrasound Guided Fine Needle Aspiration (USFNA) and Ultrasound Guided Core Needle Biopsy (USCNB)

Cited by 5 publications

References 4 publications

Ultrasound-Guided Fine-Needle Aspiration of Superficial Lymphadenopathy Performed by Interventional Pathologists: The Applicability of the Sydney System from 2 Years of Experience and 363 Cases

Ultrasound-Guided Fine-Needle Aspiration of Superficial Lymphadenopathy Performed by Interventional Pathologists: The Applicability of the Sydney System from 2 Years of Experience and 363 Cases

Amyloid goiter diagnosis by ultrasound‐guided fine needle aspiration performed by interventional pathologist

Resident training in interventional pathology: Ultrasound‐guided fine‐needle aspiration and rapid on site evaluation—5 years of teaching experience in a single university hospital

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