[On-site evaluation and triage for endoscopic ultrasound-guided fine needle aspiration cytology. The Turin experience].
OBJECTIVE
Evaluation of the importance of the on-site presence of a skilled cytopathologist during endoscopic ultrasound-guided fine needle aspiration at determining samples' adequacy and performing ancillary techniques which can be helpful for the diagnosis.


METHODS
A retrospective analysis of our institute's experience with EUS-FNA sampling is presented. From January 2001 to May 2007, 404 patients underwent the EUS-FNA evaluation. From 2003 a cytopathologist was present during the procedure and started making an extemporary evaluation of the samples' adequacy.


RESULTS
Before 2003, a final cytological diagnosis was available in only 70% of the cases (without an on-site cytopathologist). After 2003, in 90% of the cases (with an on-site cytopathologist). It is possible planning and performing: immunocytochemistry on cell block material including evaluation of the proliferation index; to obtain a sample for the flow cytometry in cases of lymphomas or a microbiologic workup in cases of infective lesions.


CONCLUSIONS
The quality of the specimens and the proper handling of the aspirated sample are very important to succesfully obtain a definitive cytological diagnosis in EUS-FNA. On-site evaluation and triage of the material allow to improve the accuracy of the diagnosis.
Campisi
P
P
Dipartimento di Scienze Biomediche e Oncologia, Università degli Studi di Torino,Torino, Italy. paolacampisi@hotmail.it
Accinelli
G
G
De Angelis
C
C
Pacchioni
D
D
Bussolati
G
G
D044963:Biopsy, Fine-Needle / Q000379:methods* / Q000592:standards; D019160:Endosonography; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007558:Italy; D010338:Pathology, Clinical / Q000458:organization & administration*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods