title: The potential of liquid-based cytology in lymph node cytological evaluation: the role of morphology and the aid of ancillary techniques.
abstract: OBJECTIVE
  Our aim was to evaluate the feasibility and diagnostic accuracy of liquid-based cytology (LBC) on lymph node fine needle aspiration (FNA). FNA may fulfil a challenging role in the evaluation of the majority of primary (benign and malignant) diagnoses as well as metastatic lymph node lesions. Although the morphological features may be quite easily recognized, cytological samples with a scant cellular component may raise some issues.
  
  
  METHODS
  We appraised 263 cytological lymph nodes from different body regions analysed between January and December 2013, including 137 male and 126 female patients, and processed with LBC.
  
  
  RESULTS
  The cytological diagnoses included 160 benign and 103 malignant lesions. We reported 35 benign and 73 malignant lesions from 108 with surgical follow-up. The latter malignant series included 68 metastatic lesions, four suspicious for malignancy and one inadequate sample. The cytological diagnoses were supported by 62 conclusive immunocytochemical and 28 molecular analyses. Of the 108 cases, we documented 35 true negatives, 72 true positives, one false negative and no false positives, resulting in 98.6% sensitivity, 100% specificity, 99% diagnostic accuracy, 97.2% negative predictive value and 100% positive predictive value.
  
  
  CONCLUSIONS
  FNA represents the first diagnostic tool in lymph node management and a reliable approach in order to avoid an excision biopsy. Furthermore, LBC is a feasible method for ancillary tests for which methanol-fixed samples are suitable, such as immunocytochemistry and molecular analysis.
authors.affiliation: Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, 'Agostino Gemelli' School of Medicine, Rome, Italy.
authors.forename: E D
authors.initials: ED
authors.lastname: Rossi
authors.affiliation: Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, 'Agostino Gemelli' School of Medicine, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Martini
authors.affiliation: Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, 'Agostino Gemelli' School of Medicine, Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Straccia
authors.affiliation: Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, 'Agostino Gemelli' School of Medicine, Rome, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Bizzarro
authors.affiliation: Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, 'Agostino Gemelli' School of Medicine, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Fadda
authors.affiliation: Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, 'Agostino Gemelli' School of Medicine, Rome, Italy.
authors.forename: L M
authors.initials: LM
authors.lastname: Larocca
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D044963:Biopsy, Fine-Needle; D004252:DNA Mutational Analysis / Q000379:methods; D066246:ErbB Receptors / Q000235:genetics; D005188:False Negative Reactions; D005189:False Positive Reactions; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: fine needle aspiration cytology; immunocytochemistry; liquid-based cytology; lymph nodes