Diagnostic Yield of Cytology and Surgical Specimen in Non–Small Cell Carcinoma of the Lung in Veteran Population in Era of Personized Diagnostic. (21st September 2018)

• Record Type: Journal Article
• Authors: Adjapong, Opoku; Jhala, Darshana
• Is Part Of: American journal of clinical pathology. Volume 150(2018)Supplement 1
• Page Start: S76
• Page End: S76
• Publication Date: 2018-09-21
• Subjects: Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqy094.184
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Objectives: To compare accuracy of non–small cell carcinoma of the lung diagnoses in cytology vs surgical specimen in achieving specific subtyping. Methods: As a part of quality assurance monitoring, a review of the VA Medical Center (Philadelphia) pathology database to identify all concurrent small biopsy, cytology, and surgical specimens with a diagnosis of non–small cell carcinoma from January 2015 to February 2018 (3-year period, n = 60) was done. Concordance of diagnoses in the two methods was assessed. The subsequent resection or immunohistochemical (IHC) stains was used to determine accuracy. Results: The definitive vs favored vs unclassified distribution, which indicated the degree of certainty, was similar for surgical and cytology. Definitive vs favored vs unclassified for surgical was 92% vs 4% vs 4%, respectively, and cytology was 90% vs 6% vs 4%, respectively. Combination of both methods increased the rate of definitive diagnosis and decreased the rate of unclassified. In discordant diagnoses (n = 5), the frequency of correct subtyping identification was similar in both surgical (n = 3) and cytology (n = 2). Contributing factors to mistyping included low cellularity, necrosis, and poor differentiation. The IHC stains were used in subtyping more in surgical than in cytology (50% vs 4%). Conclusion: Cytology is feasible and accurate for subtyping of non–small cell carcinoma of the lung. Comparable rate is achieved in using cytology or surgical specimens for accurate subtyping of non–small cell carcinoma of the lung.