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An investigation into false-negative transthoracic fine needle aspiration and core biopsy specimens.
MedLine Citation:
PMID:  24866385     Owner:  NLM     Status:  Publisher    
Transthoracic fine needle aspiration (TFNA)/core needle biopsy (CNB) under computed tomography (CT) guidance has proved useful in the assessment of pulmonary nodules. We sought to determine the TFNA false-negative (FN) rate at our institution and identify potential causes of FN diagnoses. Medical records were reviewed from 1,043 consecutive patients who underwent CT-guided TFNA with or without CNB of lung nodules over a 5-year time period (2003-2007). Thirty-seven FN cases of "negative" TFNA/CNB with malignant outcome were identified with 36 cases available for review, of which 35 had a corresponding CNB. Cases were reviewed independently (blinded to original diagnosis) by three pathologists with 15 age- and sex-matched positive and negative controls. Diagnosis (i.e., nondiagnostic, negative or positive for malignancy, atypical or suspicious) and qualitative assessments were recorded. Consensus diagnosis was suspicious or positive in 10 (28%) of 36 TFNA cases and suspicious in 1 (3%) of 35 CNB cases, indicating potential interpretive errors. Of the 11 interpretive errors (including both suspicious and positive cases), 8 were adenocarcinomas, 1 squamous cell carcinoma, 1 metastatic renal cell carcinoma, and 1 lymphoma. The remaining 25 FN cases (69.4%) were considered sampling errors and consisted of 7 adenocarcinomas, 3 nonsmall cell carcinomas, 3 lymphomas, 2 squamous cell carcinomas, and 2 renal cell carcinomas. Interpretive and sampling error cases were more likely to abut the pleura, while histopathologically, they tended to be necrotic and air-dried. The overall FN rate in this patient cohort is 3.5% (1.1% interpretive and 2.4% sampling errors). Diagn. Cytopathol. 2014;. © 2014 Wiley Periodicals, Inc.
Douglas M Minot; Elizabeth A Gilman; Marie-Christine Aubry; Jesse S Voss; Sarah G Van Epps; Delores J Tuve; Andrew P Sciallis; Michael R Henry; Diva R Salomao; Peter Lee; Stephanie K Carlson; Amy C Clayton
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-28
Journal Detail:
Title:  Diagnostic cytopathology     Volume:  -     ISSN:  1097-0339     ISO Abbreviation:  Diagn. Cytopathol.     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506895     Medline TA:  Diagn Cytopathol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Wiley Periodicals, Inc.
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