On-Site Adequacy Assessments of Fine Needle Aspiration Biopsies
Cady E Pocrnich, Michele M Weir. London Health Sciences Centre and University of Western Ontario, London, ON, Canada
Background: On-site assessment of fine needle aspiration biopsies provides valuable feedback on specimen adequacy and allows for further sampling and ancillary studies. This study sought to 1) determine the accuracy of on-site adequacy assessments (OSAA) provided by our laboratory's cytotechnologists; and 2) identify reasons for differences between OSAA and final sign-out adequacy assessment (FAA).
Design: OSAA from Oct 09- June 11 were compared to FAA. Re-review of cases with differences between OSAA and FAA was performed by comparing OSAA and FAA slides.
Results: Among 1060 cases, OSAA and FAA comparison yielded 1017 (96%) concordances and 43 (4%) differences. Six (0.5%) cases adequate at OSAA were unsatisfactory at FAA, and 37 (3.5%) cases unsatisfactory at OSAA were adequate at FAA. Reasons for differences in adequacy included: diagnostic material present only on fixed smears, ThinPrep and/or cell block (54%); amount of diagnostic material on rapid assessment smears borderline for adequacy, i.e. at “threshold” (22%); contributory clinical information (10%); and diagnostic pitfalls (10%). Slides were not available for review in 4% of cases. Diagnostic pitfalls were interpretation of lung parenchyma as neoplastic and salivary gland acinar cells as lymphocytes; and missed granulomas.
Conclusions: The accuracy of OSAA provided by our cytotechnologists is high (96%). Differences between OSAA and FAA occurred in a minority of cases with only rare cases resulting in an unsatisfactory overall outcome. Reasons for differences were most commonly due to diagnostic material on additional slides not reviewed at OSAA. An interpretative issue was identified in a small percentage of cases.
Category: Quality Assurance
Monday, March 19, 2012 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 307, Monday Morning