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Comparison of Unsatisfactory Aspirates in Fine Needle Aspiration Performed by Surgical Medical Officers and Pathologists

Kaur G, Sivakumar S

Abstract

The evaluation of fine-needle aspiration cytology (FNAC) is based on a satisfactory cell yield, which is highly operator-dependent. The aim of this study was to compare the proportion of unsatisfactory aspirates obtained by surgical medical officers and pathologists. FNAC case reports were retrospectively reviewed and cases grouped according to organ/site and person who performed the FNA procedure. An aspirate was deemed ‘adequate’ when a diagnostic report was issued; and ‘unsatisfactory’ when a report contained terms such as ‘unsatisfactory sample’ or ‘inadequate cellularity for interpretation’. The results showed of a total of 1,248 FNAC reports reviewed, 610 (48.9%) aspirations were performed by medical officers and 638 (51.2%) by pathologists. The most common organs subjected to FNA were breast (68.9%), thyroid (17%), lymph node (9.3%) and others (salivary glands and soft tissue lumps) (4.8%). The overall proportion of unsatisfactory aspirates was 16.7%. Of aspirates performed by medical officers, 26.4% were unsatisfactory compared to 7.5% obtained by pathologists (P<0.001). Pathologists had significantly lower proportion of unsatisfactory aspirates in all organs compared to medical officers. Thyroid lesions had the highest number of unsatisfactory aspirates when performed by medical officers. Hands-on training in aspiration techniques for medical officers and the use of cytospin smears and cell block in bloody thyroid aspirates will be conducted.

Journal of Cytology 2007; 24 (2) : 82-84

Key Words : Fine-needle aspiration, unsatisfactory aspirate.