Value of ancillary studies in the evaluation of fine-needle aspiration specimens: Our experience

Abstract

Background:The cytological diagnosis of poorly differentiated tumors is challenging because the tumor cells may have morphologically difficult presentations in materials obtained by fine-needle aspiration cytology (FNAC). With the application of FNAC in primary diagnosis of malignant lesions, there has been a significant increase in the use of ancillary studies in the aspirated material.Aims:We evaluated the value of ancillary studies, namely cell blocks, immunocytochemistry (ICC) and electron microscopy (EM), in the final interpretation of FNAC smears.Materials and Methods:Sixty-nine cases of neoplastic swellings were subjected to FNAC. Material acquired was divided for ICC, consisting of immunoperoxidase staining of direct smears, and/or cellblocks and EM, in addition to routine light microscopy (LM). Correlation with the available histological material with immunohistochemistry and/or pertinent clinical information was used as a “gold” standard.Results:Five (7.2%) cases were excluded from the study, the material being necrotic or insufficient. Cell blocks were available in 46/64 (71.8%) cases, ICC evaluation was performed in 41/64 cases (64%) and EM studies were done in 57/64 cases (89%). Diagnostic accuracy of LM alone was 32/64 (50%). Cell blocks improved the diagnoses in 8/46 (17%) cases. The ICC data were diagnostic in 18/41 (43.9%) cases, helpful in 8/41 (19.6%) cases and non-helpful in 15/41 (36.5%) cases. EM studies were diagnostic in 22/57 (38.5%) cases, helpful in 18/57 (31.5%) cases and non-helpful in 17/57 (30%) cases. In 34/64 (53.1%) cases, all ancillary techniques (cell blocks, ICC and EM) were applied and their diagnostic accuracy was compared.Conclusions:With appropriate case selection, ancillary studies performed on aspirated material can provide useful information in FNAC.

Diagnostic accuracy of fine-needle aspiration cytology in head and neck lesions from a tertiary health facility in Southwestern Nigeria

“…The utility of immunocytochemistry as an ancillary technique to routine cytological evaluation in FNAC of head and neck lesions is to enhance the diagnostic accuracy of FNAC. 24 …”

“…Some of the usefulness of immunocytochemistry include: differentiation between neoplastic lesions, for example separating lymphomas from carcinomas and sarcomas, helping in the characterization of lymphomas as well as differentiating primary tumors from metastatic tumours. 24 …”

From Traditional Histology to Next-Generation Pathology: A Review of The Workflow for the Characterisation and Molecular Profiling of Non-Small Cell Lung Cancer Samples

“…74 The main advantages of CB include being able to identify the architectural pattern perform ancillary techniques, such as IHC. 75,76 Differing from direct smears, CB do not require particular molecular validation as with histological material. 77 In order to evaluate the possibility of a significant reduction in neoplastic content and assess the neoplastic cellularity, it is good practice to stain first and use CB sections last.…”