Document Detail

An online quiz uncovers limitations of morphology in equivocal lung cytology.
MedLine Citation:
PMID:  17091509     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Equivocal atypia in respiratory cytology can be a diagnostic challenge. In such cases fluorescence in situ hybridization (FISH) may be used for the analysis of chromosomal aberrations and often allows a reliable distinction of benign and malignant cells. METHODS: An online picture gallery of 30 respiratory cytologic preparations comprising 23 specimens with equivocal cytology as well as 5 positive and 2 negative controls was prepared ( The final diagnoses were confirmed by clinical follow-up or biopsy or both. Each of the illustrated cell groups was analyzed by multitarget FISH after PAP image capturing and automatic relocalization. RESULTS: The online questionnaire was completed by 137 cytomorphologists from all continents. The control cases were assessed accurately to a significantly higher percentage than the equivocal cases. In equivocal cases participants more often made false-positive than false-negative diagnoses. In 2 patients with benign conditions (tuberculosis and pulmonary capillaritis) the rate of false-positive answers was remarkably high (31.4% and 62.8% respectively). The result of the 20 best-performing participants for the 5 cases with the highest percentage of inaccurate answers was not better than if they had chosen their answer by chance. CONCLUSIONS: These data illustrate that single cells or cell clusters of a subgroup of equivocal lung cytology are a diagnostic challenge even for highly experienced morphologists. Internet-based tests are able to reveal limitations of cytomorphology.
Katharina Glatz; Spasenija Savic; Dieter Glatz; Gilbert Francz; Audrey Barascud; Bruno Grilli; Michelle Herzog; Peter Dalquen; Georg Feichter; Peter Spieler; Michael Tamm; Lukas Bubendorf
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cancer     Volume:  108     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-18     Completed Date:  2007-01-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  480-7     Citation Subset:  AIM; IM    
Department for Pathology, Institute for Pathology, University Hospital, Basel, Switzerland.
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MeSH Terms
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung / genetics,  pathology*
Carcinoma, Small Cell / genetics,  pathology*
Chromosome Aberrations*
Diagnosis, Differential
In Situ Hybridization, Fluorescence
Lung / pathology*
Lung Neoplasms / genetics,  pathology*
Middle Aged
Online Systems / organization & administration*
Predictive Value of Tests

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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