Transthoracic fine-needle aspiration cytology. Analysis of 82 patients with detailed verification criteria and evaluation of false-negative cases.

The authors herein report a series of transthoracic fine-needle aspiration cytology studies performed over a ten-year period at a medical center. The verification criteria they utilized for "positive" and " nonpositive " results are unique to the TFNA literature, as is the authors' detailed analysis of false-negative cases. The authors' statistical findings included specificity, 100%; sensitivity, 79.0%; and overall accuracy, 83.0%. Eleven of 13 false-negative studies (84.6%) were consequent to sampling error; the remaining two cases (both "suspects") were the result of cytopathologist judgment error. In those patients with tissue corroboration of their lung disease, the authors obtained a 93.8% concordance rate between cytology and histology results. They conclude that uniform verification criteria, as well as careful analysis of "suspects" and false negatives, can lead to better patient care through improved quality control.