Correlation between Number of Slides and Cytological Diagnosis of Intrathoracic Tumor by Fine-needle Aspiration

  • Ponlakrit Khamrin Anatomical Pathology Department, Central Chest Institute, Nonthaburi
Keywords: fine needle aspiration, FNA slides, cytologic examination, lung tumor


Fine-needle aspiration (FNA) is the most widely used method of screening and diagnosing lesions in several organs, including intra-thoracic lesions. Overall,it is safe, fast, and minimally invasive. The FNA technique uses a sterile fine needle attached to an empty syringe. The needle is inserted into the intrathoracic lesion by ultrasound- or CT-guidance.  Then the syringe is drawn in and out to create suction. The cells or fluid are aspirated from the lesion into the needle and syringe. The contents of the syringe are smeared onto a clean glass slide for processing and evaluation. However, the number of FNA slides may vary from 1 to 16, which could affect cytological findings. This study aimed to evaluate the correlation between the number of FNA slides and the cytological diagnosis of intra-thoracic tumor. A retrospective review of intra-thoracic FNA was performed for 3782 patients at the Central Chest Institute of Thailand between 2011 and 2019. The number of slides correlated significantly with cytological diagnoses (P<0.001).  The higher number of slides submitted tends to increase the vulnerable diagnosis. Four to six slides is an appropriate number for cytological evaluation. In conclusion, the success of FNA diagnosis correlates with the number of slides submitted. The desirable number of slides ranges between 4 to 6 per case. More  than 6 is considered unnecessary.


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