Department of Pathology, State University of New York, Syracuse, New York 13210, USA.
Telemed J E Health. 2011 Dec;17(10):763-7. doi: 10.1089/tmj.2011.0052. Epub 2011 Oct 19.
Onsite evaluation of ultrasound-guided fine-needle aspiration (USGFNA) of thyroid nodules is essential to procure adequate samples and provide initial assessment. We present our experience with onsite evaluation of USGFNA of thyroid nodules using telecytopathology.
Real-time images of Diff-Quik-stained cytology smears were obtained with an Olympus Digital camera attached to an Olympus CX41 microscope and transmitted via ethernet by a cytotechnologist to a pathologist who rendered a preliminary diagnosis while communicating with an onsite cytotechnologist over the phone. Accuracy of preliminary diagnosis was compared with final diagnosis, retrospectively.
A total of 79 patients (mean age 48.9 year) underwent USGFNA of 100 thyroid nodules. Preliminary diagnoses of benign, suspicious/malignant, and unsatisfactory were 72%, 7%, and 21%, respectively. Of the 72 cases initially reported as benign all remained benign on the final cytology. Of the seven suspicious/malignant cases on initial cytology, five were suspicious/malignant and two were benign on final cytology. Of the 21 cases that were initially interpreted as unsatisfactory only four were reclassified as benign on final diagnosis. The accuracy rate between the final cytology and preliminary telecytopathology diagnosis was 94%. Presence of additional material on Papanicolaou-stained slides and cellblock sections was the main reason for discrepancy that accounted for six discrepant cases.
On-site telecytopathology for thyroid USGFNAs is highly accurate compared with final cytologic evaluation. It allows pathologists to use their time more efficiently and makes onsite evaluation at a remote site possible.
现场评估超声引导下甲状腺细针穿刺（USGFNA）获取足够样本并提供初步评估至关重要。我们展示了使用远程细胞学进行甲状腺结节 USGFNA 现场评估的经验。
使用 Olympus Digital 相机连接 Olympus CX41 显微镜获取 Diff-Quik 染色细胞学涂片的实时图像，并通过以太网由细胞技术人员传输，病理学家在与现场细胞技术人员电话沟通的同时对初步诊断进行判断。回顾性比较初步诊断的准确性与最终诊断。
共有 79 例患者（平均年龄 48.9 岁）接受了 100 个甲状腺结节的 USGFNA。初步诊断为良性、可疑/恶性和不满意分别为 72%、7%和 21%。最初报告为良性的 72 例中，所有病例最终细胞学均为良性。最初细胞学可疑/恶性的 7 例中，5 例可疑/恶性，2 例最终细胞学为良性。最初解释为不满意的 21 例中，最终诊断仅 4 例重新分类为良性。最终细胞学与初步远程细胞学诊断的准确率为 94%。Papanicolaou 染色载玻片和细胞块切片中存在额外的材料是导致 6 例差异的主要原因。
与最终细胞学评估相比，甲状腺 USGFNA 的现场远程细胞学诊断具有高度准确性。它允许病理学家更有效地利用时间，并使在远程地点进行现场评估成为可能。
