title: External quality assurance in nongynecologic cytology: The Australasian experience.
abstract: BACKGROUND
  The Royal College of Pathologists of Australasia Cytopathology Quality Assurance Program has operated an external quality assurance program in nongynecologic cytopathology since 1993. Glass slide preparations of a wide range of nongynecologic cases were circulated to approximately 200 cytopathology laboratories in 16 countries.
  
  
  METHODS
  General nongynecologic cytology cases were manufactured from residual specimens after routine diagnosis. Fine-needle aspiration (FNA) cases were made by sampling fresh tissue and making direct specimens. The majority of cases consisted of both air-dried and fixed preparations. Results returned to laboratories included illustrated case discussions highlighting diagnostic features, key differential diagnoses, and useful adjunctive tests.
  
  
  RESULTS
  The current study reviewed >22,000 results for 123 nongynecologic cases. Cases found to cause the most diagnostic difficulties included serous effusion cases with metastatic carcinoma in a dispersed pattern, well-differentiated carcinoma, and cellular reactive cases; urine specimens with sparse malignant cells; reactive pneumocytes in a bronchoalveolar lavage; breast FNA cases with papillary lesions; gestational specimens; and fibroadenoma. FNA specimens from the lung and thyroid, particularly papillary thyroid carcinoma, generally were well reported.
  
  
  CONCLUSIONS
  The use of multiple preparations of the same specimen has allowed interlaboratory comparison, and the quality assurance program has played an educational role as well as informing the laboratory accreditation process. Cancer Cytopathol 2017;125:349-361. © 2017 American Cancer Society.
authors.affiliation: School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.|Sullivan Nicolaides Pathology, Bowen Hills, Brisbane, Queensland, Australia.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Shield
authors.affiliation: PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia.
authors.forename: Felicity
authors.initials: F
authors.lastname: Frost
authors.affiliation: School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Jo L
authors.initials: JL
authors.lastname: Finnimore
authors.affiliation: Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia.
authors.forename: R Gordon
authors.initials: RG
authors.lastname: Wright
authors.affiliation: Pathology Queensland, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Cummings
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D001202:Ascitic Fluid / Q000166:cytology; D044362:Australasia; D044963:Biopsy, Fine-Needle; D001826:Body Fluids / Q000166:cytology*; D001943:Breast Neoplasms / Q000473:pathology; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D002276:Carcinoid Tumor / Q000473:pathology; D002277:Carcinoma / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology; D002291:Carcinoma, Papillary; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D002295:Carcinoma, Transitional Cell / Q000473:pathology; D003581:Cytodiagnosis / Q000592:standards*; D018226:Fibroadenoma / Q000473:pathology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology; D008545:Melanoma / Q000473:pathology; D008654:Mesothelioma / Q000473:pathology; D009369:Neoplasms / Q000473:pathology*; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000473:pathology; D010338:Pathology, Clinical / Q000592:standards*; D000069236:Pericardial Fluid / Q000166:cytology; D011785:Quality Assurance, Health Care / Q000379:methods*; D055752:Small Cell Lung Carcinoma / Q000473:pathology; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology; D014556:Urine / Q000166:cytology
keywords: exfoliative cytology; fine-needle aspiration cytology; nongynecologic cytology; quality assurance