Gross Appearance of Fine Needle Aspiration Smears: Can Adequacy of the Sample be Assessed and Correlated with their Microscopic Cytological Yield.

BACKGROUND

Fine needle aspiration cytology (FNAC) is a simple procedure that is widely accepted as a first-line investigation. It should ideally be performed near the patient with microscopic assessment for evaluation of adequacy of aspirate. Since this is not always possible, a worthwhile substitute is to assess the gross appearance of the material obtained. This study was aimed to determine the value of this alternative rapid, bed-side approach.

METHOD

This study was carried out in a tertiary care hospital for a duration of 1 year, where 50 cases undergoing FNAC in the out-patient department (OPD) were included. Unstained smears of commonly encountered lesions were photographed and assessed by three independent observers, who graded them into four grades, viz. . Results were subsequently compared with the microscopic findings of stained smears.

RESULTS

Distribution of the 50 cases between grades 1, 2, 3, and 4 were 5, 6, 17, and 22, respectively.

CONCLUSION

Gross appearances of FNA smears are helpful in predicting the adequacy of the sample and sometimes the final microscopic diagnosis. The cellularity of a sample can be gauged by inspection and sometimes a likely diagnosis can be made. Some lesions show typical gross appearance easily detected by the experienced eye so a likely diagnosis can be predicted prior to microscopic examination. However, near-patient microscopic assessment of FNA specimens for rapid onsite evaluation, if available, should be the preferred mode.