Positive economic and diagnostic accuracy impacts of on-site evaluation of fine needle aspiration biopsies by pathologists

Acta Cytologica
H A Saleh, G Khatib

Abstract

To investigate the impact of pathologists' immediate evaluation of fine needle aspiration biopsy (FNAB) on increasing diagnostic yield and decreasing related expenses. All FNABs performed at our 420-bed hospital between January 1992 and December 1994 were reviewed. The 1992-1993 FNABs were all performed without pathologist attendance. Smears were wet fixed in 95% alcohol and later stained by the Papanicolaou or hematoxylin and eosin methods. The remaining aspirated material was collected in Saccomano's preservative, and a cell block was made. Nearly all the 1994 FNABs were performed with the pathologist present; he examined air-dried, Diff-Quik-stained smears for preliminary evaluation of the aspirate. An average of three passes were done. The rest of the procedure was as usual. The total number of 1992-1993 FNABs was 227 (108 + 119); of them, 104 (46%) were inadequate for diagnosis. In contrast, the 1994 FNABs totaled 169, with only 40 (24%) inadequate for diagnosis. The vast majority of the aspirates were done on deep-seated lesions under computed tomography (CT) guidance. The results of our experience indicate that on-site evaluation by a pathologist greatly increases the diagnostic yield. Another advantage is the significan...Continue Reading

Citations

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