Comparison of specimen adequacy in fine-needle aspiration biopsies performed by surgeons and pathologists.
BACKGROUND
Fine-needle aspiration biopsy (FNAB) may yield different results depending on its operator. We compared the proportions of unsatisfactory aspirates obtained by pathologists vs. surgeons.


METHODS
In a retrospective review, all FNAB reports and slides performed between March 2002 and February 2003 were grouped by organ/site and according to whether they were done by a pathologist or a surgeon. The proportions of unsatisfactory aspirates for pathologists and surgeons were compared.


RESULTS
Of 692 FNABs, 390 were performed by pathologists at the FNAC clinic and the remainder by surgeons. Overall, 15.5% of aspirates obtained were unsatisfactory (n=107). Of aspirates obtained by surgeons, 29.5% were unsatisfactory, compared to 4.6 % of those obtained by pathologists (P<0.001). Pathologists had significantly lower proportions of unsatisfactory aspirates in all sites. A 33% reduction in the number of lymph node excisional biopsies has been reported subsequent to establishment of the FNAC clinic.


CONCLUSIONS
The advantages of a pathologist performing FNAB are that a rapid evaluation can be rendered regarding specimen adequacy and the need for repeating the procedure. In addition, pathologists can direct the distribution of aspirated material for other tests such as culture study, flow cytometry and electron microscopy, as indicated by preliminary evaluation of the smears. These factors significantly lower the proportions of unsatisfactory specimens and improve the diagnostic accuracy of FNAB technique.
Department of Pathology, King Fahad Hospital-Hofuf Al-Hassa, Saudi Arabia. ymarz@hotmail.com
Yusef M
YM
Al-Marzooq
Rajan
R
Chopra
Ahmed T
AT
Al-Bahrani
Mohammad
M
Younis
Abdulrahman S
AS
Al-Mulhim
Mohammed I
MI
Al-Mommatten
D044963:Biopsy, Fine-Needle; D001940:Breast / Q000473:pathology; D001941:Breast Diseases / Q000473:pathology; D005260:Female; D013502:General Surgery; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D010336:Pathology; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D013048:Specimen Handling; D013959:Thyroid Diseases / Q000473:pathology; D013961:Thyroid Gland / Q000473:pathology