Cell block is a valuable adjunct to conventional smear for thyroid fine needle aspiration: 2395 cases with histological correlation.

Published on Dec 1, 2018in Cytopathology2.073
· DOI :10.1111/CYT.12633
Ke Jiang7
Estimated H-index: 7
(Sichuan University),
Junyi Zhou1
Estimated H-index: 1
(Sichuan University)
+ 7 AuthorsJingqiang Zhu18
Estimated H-index: 18
(Sichuan University)
Sources
Abstract
AIMS: Conventional smears (CS) of samples obtained by fine needle aspiration (FNA) have proven useful in thyroid nodules evaluation, but the additional contribution of cell block (CB) has only been investigated in a limited fashion. In this study, we aimed to evaluate whether the auxiliary application of CB adds to the diagnostic accuracy of the CS by a College of American Pathologists-accredited hospital laboratory. METHODS: All thyroid FNA samples processed with CS only or combined CB and CS in West China Hospital from January 2011 to December 2015 were retrospectively collected. All specimens were classified according to Bethesda System, and the distribution of Bethesda (2009) categories was compared between CS and combined CS and CB. Further, we compared the diagnostic performance between these two groups for nodules with follow-up histopathology. RESULTS: A total of 11 011 thyroid nodules from 10 206 patients were included. Of these, 2395 nodules from 2211 patients underwent surgical resection. The unsatisfactory rate decreased significantly from 18.1% to 9.8% in the total group and from 1.7% to 0.8% in the group with surgery after combined use of CS and CB. The proportion of atypia/follicular lesion of undetermined significance also declined slightly. Furthermore, all of the sensitivities, specificities, accuracies and positive predictive values increased significantly after the combined use of CS and CB for different calculation methods. CONCLUSIONS: Combined use of CS and CB can significantly decrease the unsatisfactory rate of thyroid FNAs, improve the diagnostic efficacy, and thus should be routinely applied in thyroid nodule evaluation if available.
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References31
Newest
#1Nilgün Yılmaz Demirci (Gazi University)H-Index: 9
#2Asiye Ugras Dikmen (Gazi University)H-Index: 6
Last. Can Öztürk (Gazi University)H-Index: 10
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Introduction: It is crucial to diagnose the subtype of lung cancer quickly and accurately for effective therapy. Conventional cytology staining sometimes provides limited information, and additional tissue is often required to diagnose lung cancer. Cell blocks (CB) recovered during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) increases the diagnostic accuracy of the procedure and the likelihood of additional valuable histochemical and immunohistochemical staining....
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#1Yosep Chong (Catholic University of Korea)H-Index: 11
#2Soon-Jin Ji (Catholic University of Korea)H-Index: 1
Last. Eun-Jung Lee (Catholic University of Korea)H-Index: 25
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OBJECTIVE: Conventional smear (CS) using fine-needle aspiration cytology (FNAC) has been established as the test of choice for diagnosing thyroid lesions, despite low sample adequacy and inter-individual variations. Although a liquid-based preparation (LBP) technique has been recently applied to overcome these limitations, its clinical utility and its accuracy over CS are controversial. This study aimed to determine the true sensitivity and specificity of LBP in thyroid FNAC by meta-analysis. DE...
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#1Onur Fevzi ErerH-Index: 5
#2Serhat ErolH-Index: 7
Last. Serir Aktogu OzkanH-Index: 5
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Aim: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe and minimally invasive procedure that can be performed in outpatient settings. Several studies have demonstrated the usefulness of EBUS-TBNA in the diagnosis of sarcoidosis and malignant diseases. This study focused on the role of cell block (CB) analysis in determining the diagnostic yield of EBUS-TBNA in malignant diseases and sarcoidosis. Materials and Methods: The study was conducted at a training and...
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#10Syed Z. Ali (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 43
Aims The distinction between benign and malignant thyroid nodules has important therapeutic implications. Our objective was to develop an assay that could classify indeterminate thyroid nodules as benign or suspicious, using routinely prepared fine needle aspirate (FNA) cytology smears. Methods A training set of 375 FNA smears was used to develop the microRNA-based assay, which was validated using a blinded, multicentre, retrospective cohort of 201 smears. Final diagnosis of the validation sampl...
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#1Ana Patrícia de Cristo (UFRGS: Universidade Federal do Rio Grande do Sul)H-Index: 3
#2Heloísa Folgierini Goldstein (UFRGS: Universidade Federal do Rio Grande do Sul)H-Index: 1
Last. Márcia Silveira Graudenz (UFRGS: Universidade Federal do Rio Grande do Sul)H-Index: 10
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Objective Ultrasound-guided fine-needle aspiration (US-FNA) biopsy has proven to be an accurate and efficient tool in thyroid nodule evaluation. We evaluated whether cell block adds to the diagnostic accuracy of US-FNA. Subjects and methods Three hundred twenty-eight consecutive patients underwent US-FNA, cytology and cell block evaluation. Six slides were prepared for each patient and stained by Papanicolaou and Giemsa techniques. The residual hemorrhagic aspirate in the syringe and needle was ...
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#1Soo Yeon Kim (Yonsei University)H-Index: 21
#2Eun Kyung Kim (Yonsei University)H-Index: 73
Last. Jin Young Kwak (Yonsei University)H-Index: 60
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The purpose of the study was to compare the diagnostic utility of the combined conventional smear (CS) and liquid-based preparation (LBP) compared to CS with respect to the non-diagnostic rate, the atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) rate, and the diagnostic performances for malignancy. This retrospective study was approved by the Institutional Review Board, and the need to obtain informed consent was waived. In our institution, thyr...
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#1Franz G. WuertzH-Index: 1
#2Ewald KresnikH-Index: 23
Last. Hans J. GallowitschH-Index: 5
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Objective: To evaluate the diagnostic accuracy of a modified scrape cell block (SCB) technique in a large series of patients. The technique was especially developed and tested for fine-needle aspiration of thyroid and parathyroid nodules. Study Design: Eighty-two ultrasound-guided fine-needle aspiration specimens with the sonographic aspect of a thyroid (n = 33) or a possible parathyroid nodule (n = 49) were studied. Immunohistochemistry (IHC) was used on cell blocks containing plasma, thrombopl...
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#1Neeraja Nagarajan (Johns Hopkins University)H-Index: 18
#2Eric B. Schneider (Johns Hopkins University)H-Index: 58
Last. Matthew T. OlsonH-Index: 21
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Background: Fine-needle aspiration (FNA) plays a pivotal role in the initial evaluation of patients with thyroid nodules. Traditionally, aspirated material is expelled directly onto the microscope slide to make a conventional smear (CS). Recently, liquid-based preparations (LBP) have gained in popularity. This study compares the accuracy of these two preparation techniques in diagnosing thyroid nodules. Methods: A clinical database containing 5475 thyroid cytology consults from 2009 to 2013 was ...
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#1Deepali Jain (AIIMS: All India Institute of Medical Sciences)H-Index: 26
#2Sandeep Mathur (AIIMS: All India Institute of Medical Sciences)H-Index: 16
Last. Venkateswaran K. Iyer (AIIMS: All India Institute of Medical Sciences)H-Index: 17
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The cell block (CB) is a routine procedure in cytopathology that has gained importance because of its pivotal role in diagnosis and ancillary studies. There is no precise review in the published literature that deals with the various methods of preparation of CB, its utility in diagnosis, immunocytochemistry (ICC) or molecular testing, and its drawbacks. An extensive literature search on CB in cytology using internet search engines was performed for this review employing the following keywords: ...
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#1Shanyu Qin (Guangxi Medical University)H-Index: 15
#2You Zhou (Minerva Foundation Institute for Medical Research)H-Index: 26
Last. Hai-Xing Jiang (Guangxi Medical University)H-Index: 15
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Background The diagnostic efficiency of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology varies widely depending on the treatment method of the specimens. The present study aimed to evaluate the diagnostic efficacy of cell block (CB) immunohistochemistry, smear cytology (SC), and liquid-based cytology (LBC) in patients with pancreatic lesions without consulting an on-site cytopathologist.
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Cited By3
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#1Jianming Li (Capital Medical University)H-Index: 1
#2Huarong LiH-Index: 1
Last. Linxue Qian (Capital Medical University)H-Index: 1
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OBJECTIVE: To compare the value of the thyroid imaging reporting and data system proposed by Kwak (KWAK TI-RADS) and the 2015 American Thyroid Association (ATA) guidelines for diagnosis of medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC). To confirm the role of cell block (CB)-assisted fine-needle aspiration (FNA) in final diagnosis of MTC. DESIGN: Retrospective hospital-based cohort study. PATIENTS: Ninety-three patients with 29 MTCs, 31 PTCs and 33 thyroid adenomas (TAs)...
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#1Juan Zhao (ZJU: Zhejiang University)H-Index: 1
#2Xiaofei Yao (ZJU: Zhejiang University)H-Index: 1
Last. Cheng Wang (ZJU: Zhejiang University)H-Index: 1
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BACKGROUND: As thyroid fine needle aspiration (FNA) shows a certain limitation in the diagnosis of conventional smears, novel approaches like liquid-based cytology (LBC) have been gradually applied recently. Studies have shown the difference between the conventional smears (CSs) and liquid-based smears on fine needle aspiration cytology (FNAC) diagnosis, but the impacts of different liquid-based preparation (LBP) methods, including membrane-based and sedimentation, on diagnosis are still not cle...
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#1Jesse Vance (Texas Tech University Health Sciences Center at El Paso)H-Index: 2
#2Karen Durbin (Texas Tech University Health Sciences Center at El Paso)H-Index: 1
Last. Syed M. Gilani (Texas Tech University Health Sciences Center at El Paso)H-Index: 1
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BACKGROUND: This study was conducted to evaluate the diagnostic utility of cell block material in fine needle aspiration (FNA) of thyroid nodules. DESIGN: A total of 242 thyroid fine need aspirations (FNAs) were performed between January 2015 and December 2015. Of those, all consecutive thyroid FNA cases with cell blocks (n = 140) from 129 patients (age: 58.9 ± 12.8 years) are included in this study. Cytology slides and cell blocks are reviewed for adequacy assessment based on the Bethesda Syste...
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