Qiu Libo, Crapanzano John P, Saqi Anjali, Vidhun Ramapriya, Vazquez Madeline F
Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York 10021, USA.
Acta Cytol. 2008 Mar-Apr;52(2):139-44. doi: 10.1159/000325471.
To study diagnostic efficacy of direct smears (DS) vs. cell block (CB) alone in hemorrhagic thyroid fine needle aspirations (FNAs) performed without a cytotechnologist or cytopathologist.
Ultrasound-guided thyroid FNAs from an offsite location were retrospectively searched during a 53-month period. Aspirates in the initial 13 months were submitted as air-dried DSs. Subsequent specimens were submitted as CBs. Each case was classified into 1 of 4 categories: (1) nondiagnostic, (2) nonneoplastic, (3) follicular lesions and (4) papillary thyroid carcinoma (PTC).
There were 77 aspirates: DS = 20 (26%) and CB = 57 (74%). Two cases had both DSs and CBs. Diagnoses of DS: nondiagnostic = 12 (60%); nonneoplastic = 7 (35%); follicular lesion = 1 (5%). Diagnoses of CB cases: nondiagnostic = 4 (7.0%); nonneoplastic = 43 (75.4%); follicular lesion, including 1 Hürthle cell neoplasm = 7 (12.3%), PTC = 3 (5.3%). Repeat FNAs on 4 nondiagnostic cases (3 DSs, 1 CB) utilizing the CB-only technique were diagnostic and included nodular goiter, follicular neoplasm, PTC, and reactive lymph node.
Without onsite assessment, CB alone is superior to DSs for hemorrhagic thyroid FNAs. It shows increased diagnostic efficacy and slide reduction and obviates repeat FNAs.
研究在没有细胞技术人员或细胞病理学家参与的情况下，直接涂片（DS）与单独细胞块（CB）在出血性甲状腺细针穿刺抽吸术（FNA）中的诊断效能。
回顾性检索了53个月期间从异地进行的超声引导下甲状腺FNA。最初13个月的抽吸物制成空气干燥的DS。随后的标本制成CB。每个病例分为4类中的1类：（1）无法诊断，（2）非肿瘤性，（3）滤泡性病变和（4）甲状腺乳头状癌（PTC）。
共有77例抽吸物：DS = 20例（26%），CB = 57例（74%）。2例同时有DS和CB。DS的诊断结果：无法诊断 = 12例（60%）；非肿瘤性 = 7例（35%）；滤泡性病变 = 1例（5%）。CB病例的诊断结果：无法诊断 = 4例（7.0%）；非肿瘤性 = 43例（75.4%）；滤泡性病变，包括1例许特莱细胞肿瘤 = 7例（12.3%），PTC = 3例（5.3%）。对4例无法诊断的病例（3例DS，1例CB）采用仅细胞块技术进行重复FNA具有诊断价值，包括结节性甲状腺肿、滤泡性肿瘤、PTC和反应性淋巴结。
在没有现场评估的情况下，单独使用CB在出血性甲状腺FNA中优于DS。它显示出更高的诊断效能，减少了玻片数量，避免了重复FNA。
