title: Cytomorphology is often insufficient to categorize non-small-cell lung carcinoma on FNA specimens.
abstract: OBJECTIVE
  To determine the accuracy and reproducibility of differentiating between squamous cell carcinoma (SCC) and adenocarcinoma (ADC) on fine-needle aspiration (FNA) specimens.
  
  
  METHODS
  Fifty cases of NSCLC diagnosed by FNA having either concurrent core biopsies or resection as a diagnostic reference standard were selected. FNA slides were reviewed independently by five blinded observers. Two rounds of review were performed. Cases were initially categorized as SCC, favor SCC, NSCLC (type indeterminate), favor ADC, or ADC; while the indeterminate category was eliminated in the second round of review.
  
  
  RESULTS
  The interobserver agreement was 0.22 and 0.1 with and without the indeterminate category, respectively. The overall accuracy for differentiating between SCC and ADC of the lung was 65% with the indeterminate category and 66% without.
  
  
  CONCLUSIONS
  Overall, the low interobserver agreement in our study indicates that accurate subclassification between the NSCLCs often cannot be made by cytomorphology alone.
authors.affiliation: Department of Pathology/ARUP Laboratories, University of Utah School of Medicine, Utah.
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Witt
authors.affiliation: Department of Pathology/ARUP Laboratories, University of Utah School of Medicine, Utah.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Cohen
authors.affiliation: Department of Pathology/ARUP Laboratories, University of Utah School of Medicine, Utah.
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Chadwick
authors.affiliation: Department of Pathology/ARUP Laboratories, University of Utah School of Medicine, Utah.
authors.forename: Philip D
authors.initials: PD
authors.lastname: Stephenson
authors.affiliation: Department of Pathology/ARUP Laboratories, University of Utah School of Medicine, Utah.
authors.forename: Peter
authors.initials: P
authors.lastname: Abasolo
authors.affiliation: Department of Pathology/ARUP Laboratories, University of Utah School of Medicine, Utah.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Schmidt
mesh_terms: D044963:Biopsy, Fine-Needle / Q000592:standards; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D015588:Observer Variation; D012680:Sensitivity and Specificity
keywords: FNA; accuracy; agreement; non-small-cell lung carcinoma