1. Cell Block Alone as an Ideal Preparatory Method for Hemorrhagic Thyroid Nodule Aspirates Procured Without Onsite Cytologists
- Author
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Ramapriya Vidhun, Libo Qiu, Madeline Vazquez, John P. Crapanzano, and Anjali Saqi
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Tissue Fixation ,Histology ,Goiter ,Cost-Benefit Analysis ,Biopsy, Fine-Needle ,Hemorrhage ,Pathology and Forensic Medicine ,Thyroid carcinoma ,Predictive Value of Tests ,Follicular phase ,Humans ,Medicine ,Thyroid Neoplasms ,Thyroid Nodule ,Lymph node ,Ultrasonography, Interventional ,Cell block ,Aged ,Retrospective Studies ,Aged, 80 and over ,Tissue Embedding ,business.industry ,Thyroid ,Nodule (medicine) ,Anatomical pathology ,General Medicine ,Middle Aged ,medicine.disease ,Carcinoma, Papillary ,medicine.anatomical_structure ,Female ,Clinical Competence ,medicine.symptom ,business - Abstract
OBJECTIVE To study diagnostic efficacy of direct smears (DS) vs. cell block (CB) alone in hemorrhagic thyroid fine needle aspirations (FNAs) performed without a cytotechnologist or cytopathologist. STUDY DESIGN Ultrasound-guided thyroid FNAs from an offsite location were retrospectively searched during a 53-month period. Aspirates in the initial 13 months were submitted as air-dried DSs. Subsequent specimens were submitted as CBs. Each case was classified into 1 of 4 categories: (1) nondiagnostic, (2) nonneoplastic, (3) follicular lesions and (4) papillary thyroid carcinoma (PTC). RESULTS There were 77 aspirates: DS = 20 (26%) and CB = 57 (74%). Two cases had both DSs and CBs. Diagnoses of DS: nondiagnostic = 12 (60%); nonneoplastic = 7 (35%); follicular lesion = 1 (5%). Diagnoses of CB cases: nondiagnostic = 4 (7.0%); nonneoplastic = 43 (75.4%); follicular lesion, including 1 Hurthle cell neoplasm = 7 (12.3%), PTC = 3 (5.3%). Repeat FNAs on 4 nondiagnostic cases (3 DSs, 1 CB) utilizing the CB-only technique were diagnostic and included nodular goiter, follicular neoplasm, PTC, and reactive lymph node. CONCLUSION Without onsite assessment, CB alone is superior to DSs for hemorrhagic thyroid FNAs. It shows increased diagnostic efficacy and slide reduction and obviates repeat FNAs.
- Published
- 2008