用于辅助研究的胸部小活检和细胞学标本的采集与处理：美国病理学家学会与美国胸科医师学会、分子病理学协会、美国细胞病理学学会、美国胸科学会、肺病理学协会、帕潘icolaou细胞病理学学会、介入放射学会和胸部放射学会合作制定的指南

Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies: Guideline From the College of American Pathologists in Collaboration With the American College of Chest Physicians, Association for Molecular Pathology, American Society of Cytopathology, American Thoracic Society, Pulmonary Pathology Society, Papanicolaou Society of Cytopathology, Society of Interventional Radiology, and Society of Thoracic Radiology.

作者信息

Roy-Chowdhuri Sinchita, Dacic Sanja, Ghofrani Mohiedean, Illei Peter B, Layfield Lester J, Lee Christopher, Michael Claire W, Miller Ross A, Mitchell Jason W, Nikolic Boris, Nowak Jan A, Pastis Nicholas J, Rauch Carol Ann, Sharma Amita, Souter Lesley, Billman Brooke L, Thomas Nicole E, VanderLaan Paul A, Voss Jesse S, Wahidi Momen M, Yarmus Lonny B, Gilbert Christopher R

机构信息

From the Department of Pathology, The University of Texas, MD Anderson Cancer Center, Houston (Dr Roy-Chowdhuri); Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, Washington (Dr Gilbert); the Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Dacic); the Department of Pathology, PeaceHealth Southwest Medical Center, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland (Dr Illei); the Department of Pathology and Anatomic Sciences, University of Missouri, Columbia (Dr Layfield); the Department of Radiology, Keck Medical Center of the University of Southern California, Los Angeles (Dr Lee); the Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Dr Michael); Memorial Pathology Consultants, PA, Houston, Texas (Dr Miller); the Department of Radiology, Capital Regional Medical Center, Tallahassee, Florida (Dr Mitchell); the Department of Interventional and Vascular Radiology, Cooley Dickinson Hospital, Northampton, Massachusetts (Dr Nikolic); the Department of Pathology and Laboratory Medicine, Roswell Park Cancer Institute, Buffalo, New York (Dr Nowak); the Division of Pulmonary and Critical Care, Medical University of South Carolina, Charleston (Dr Pastis); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Rauch); the Department of Radiology, Massachusetts General Hospital, Boston (Dr Sharma); the Methodology Consultant, Ontario, Canada (Dr Souter); the Departments of Governance Services (Ms Billman) and Surveys (Ms Thomas), College of American Pathologists, Northfield, Illinois; the Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (Dr VanderLaan); the Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota (Mr Voss); the Division of Pulmonary, Allergy and Critical Care, Duke University School of Medicine, Durham, North Carolina (Dr Wahidi); and the Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD (Dr Yarmus).

出版信息

Arch Pathol Lab Med. 2020 May 13. doi: 10.5858/arpa.2020-0119-CP.

DOI:10.5858/arpa.2020-0119-CP

PMID:32401054

Abstract

CONTEXT.—: The need for appropriate specimen use for ancillary testing has become more commonplace in the practice of pathology. This, coupled with improvements in technology, often provides less invasive methods of testing, but presents new challenges to appropriate specimen collection and handling of these small specimens, including thoracic small biopsy and cytology samples.

OBJECTIVE.—: To develop a clinical practice guideline including recommendations on how to obtain, handle, and process thoracic small biopsy and cytology tissue specimens for diagnostic testing and ancillary studies.

METHODS.—: The College of American Pathologists convened an expert panel to perform a systematic review of the literature and develop recommendations. Core needle biopsy, touch preparation, fine-needle aspiration, and effusion specimens with thoracic diseases including malignancy, granulomatous process/sarcoidosis, and infection (eg, tuberculosis) were deemed within scope. Ancillary studies included immunohistochemistry and immunocytochemistry, fluorescence in situ hybridization, mutational analysis, flow cytometry, cytogenetics, and microbiologic studies routinely performed in the clinical pathology laboratory. The use of rapid on-site evaluation was also covered.

RESULTS.—: Sixteen guideline statements were developed to assist clinicians and pathologists in collecting and processing thoracic small biopsy and cytology tissue samples.

CONCLUSIONS.—: Based on the systematic review and expert panel consensus, thoracic small specimens can be handled and processed to perform downstream testing (eg, molecular markers, immunohistochemical biomarkers), core needle and fine-needle techniques can provide appropriate cytologic and histologic specimens for ancillary studies, and rapid on-site cytologic evaluation remains helpful in appropriate triage, handling, and processing of specimens.

摘要

背景

在病理学实践中，合理使用标本进行辅助检测的需求已变得越来越普遍。这与技术进步相结合，常常提供了侵入性较小的检测方法，但也给这些小标本（包括胸部小活检和细胞学样本）的恰当采集和处理带来了新挑战。

目的

制定一项临床实践指南，包括关于如何获取、处理和加工胸部小活检及细胞学组织标本以进行诊断检测和辅助研究的建议。

方法

美国病理学家学会召集了一个专家小组，对文献进行系统回顾并制定建议。核心针吸活检、触摸涂片、细针抽吸以及患有包括恶性肿瘤、肉芽肿性病变/结节病和感染（如结核病）等胸部疾病的积液标本被视为在研究范围内。辅助研究包括免疫组织化学和免疫细胞化学、荧光原位杂交、突变分析、流式细胞术、细胞遗传学以及临床病理实验室常规进行的微生物学研究。还涵盖了快速现场评估的应用。