Frequency and rationale of fine needle aspiration biopsy conversion to core biopsy as a result of onsite evaluation.
OBJECTIVE
To measure the frequency and analyze the rationale and potential diagnostic benefits of converting the fine needle aspiration (FNA) procedure to core biopsy.


METHODS
The frequency of conversion to core biopsy was calculated over 13 months. Analysis of these cases was conducted in regard to the appropriateness for conversion and whether the core biopsy provided additional specific diagnostic information.


RESULTS
During this period, the onsite triaging pathologist recommended FNA conversion to core biopsy in 31 of 821 procedures (3.7%). In 3 instances, the core biopsy could not be performed. The rationale for conversion in the remaining 28 cases (3.4%) included either scant aspirated material in 9 cases (32%) or an anticipated need for additional histologic material to further characterize the lesion in the other 19 (68%). In 27 cases (96%), the rationale for conversion was considered to be appropriate, and in 3 of these (11%) the core provided a change in diagnosis. Additional useful diagnostic information was identified in 12 cases (44%).


CONCLUSIONS
Conversion to core biopsy during FNA is infrequent but justified in most cases. Appropriate utilization of this approach is helpful and may be cost effective.
Bandyopadhyay
Sudeshna
S
Department of Pathology, Wayne State University School of Medicine and the Barbara Ann Karmanos Cancer Center, Detroit, Michigan, USA.
Pansare
Vaishali
V
Feng
Jining
J
Ali-Fehmi
Rouba
R
Bhan
Raj
R
Husain
Mujtaba
M
Al-Abbadi
Mousa A
MA
D044963:Biopsy, Fine-Needle / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D001707:Biopsy, Needle / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D042241:Early Diagnosis; D006801:Humans; D009369:Neoplasms / Q000473:pathology*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies