An evaluation of nondiagnostic fine needle aspiration biopsy results: the importance of having an experienced cytopathologist

Aim: To compare nondiagnostic fine needle aspiration biopsy cytology results between pathologists and clinicians. Fine needle aspiration biopsy has proven to be a safe, economical, accurate, and rapid diagnostic technique. A successful aspiration biopsy requires a specimen with adequate cellularity, high-quality preparation, an experienced physician, and a cytopathologist. Up to 32% of fine needle aspiration biopsies of various organs (thyroid, breast, etc.) may ultimately be nondiagnostic due to scant cellularity and poor preparation.Materials and methods: A total of 2247 reports of fine needle aspiration biopsies were reviewed, all obtained from files in the Pathology Laboratory of the İzmir Atatürk Training and Research Hospital. The reports included specimens from thyroids, breasts, lymph nodes, and salivary glands. Data from the fine needle aspiration biopsies were reviewed by physicians; for each case, both clinicians and cytopathologists were consulted in order to determine the clinical utility and the cost-effectiveness of the evaluation of aspiration biopsies.Results: Our database showed that nondiagnostic cytology results obtained by clinicians alone were higher (34.1%) than those of cytopathologists (2.8%).Conclusion: We conclude that the evaluation of fine needle aspiration biopsies involving cytopathologists not only substantially increases the adequacy of cytology specimens and decreases the number of nondiagnostic specimens, but it also increases the cost-effectiveness of the procedure.