Rapid On-Site Evaluation has High Diagnostic Yield Differentiating Adenocarcinoma vs Squamous Cell Carcinoma of Non-Small Cell Lung Carcinoma, not Otherwise Specified Subgroup
PATHOLOGY & ONCOLOGY RESEARCH, vol.21, no.1, pp.167-172, 2015 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 21 Issue: 1
- Publication Date: 2015
- Doi Number: 10.1007/s12253-014-9802-x
- Journal Name: PATHOLOGY & ONCOLOGY RESEARCH
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Page Numbers: pp.167-172
- Keywords: Cytology, Lung carcinoma, Non-small cell lung carcinoma, On-site cytologic evaluation, Subclassification, FINE-NEEDLE-ASPIRATION, ENDOBRONCHIAL ULTRASOUND, CYTOLOGY, CANCER, CYTOPATHOLOGIST, BIOPSY
- Open Archive Collection: AVESIS Open Access Collection
- Akdeniz University Affiliated: Yes
Abstract
Our objective was to evaluate the diagnostic yield of rapid on-site evaluation (ROSE) on the differential diagnosis of non-small cell lung carcinoma, not otherwise specified (NSCLC-NOS). Biopsied cases diagnosed as NSCLC-NOS with ROSE during 2004 through 2008 were retrieved. Diagnostic confirmation was done with immunohistochemistry (IHC) involving thyroid transcription factor-1 and p63 immunostains. For the study, 106 cases were available. The final diagnoses rendered were squamous cell carcinoma (SqCC) (n = 39) and adenocarcinoma (AC) (n = 67). Cytologic, histologic, and IHC concordance for these diagnoses occurred in 75 cases (70.8 %), of which 56 (52.8 %) were AC and 19 (17.9 %) were SqCC. Cytologic, histologic, and IHC discordance was found in 31 cases (29.2 %). Of these 31 cases, 11 NSCLC-NOS diagnoses histologically corresponded to 1 SqCC plus 4 ACs, and 4 favor SqCC plus 2 ACs; the former 5 NSCLC-NOS cases classified correctly through cytology, as well as IHC. However, IHC was not available for the latter 6 NSCLC-NOS cases that were also classified correctly through cytology. In addition, only 3 NSCLC-NOS diagnoses cytologically corresponded to 3 favor SqCC histologically, in which IHC was not available, and for 2 cases that both corresponded to favor SqCC and favor AC histologically and cytologically. In the other 15 cases, histology labeled 4 cases NSCLC-NOS and misclassified 2 cases; cytology labeled 1 case NSCLC-NOS and misclassified 13 cases. ROSE has high diagnostic yield over subclassification of NSCLC-NOS. We recommend allocating a cytotechnologist for specimen adequacy and a cytopathologist for cytologic diagnosis.