An investigation into false-negative transthoracic fine needle aspiration and core biopsy specimens

Douglas M. Minot, Elizabeth A. Gilman, Marie Christine Aubry, Jesse S. Voss, Sarah G. Van Epps, Delores J. Tuve, Andrew P. Sciallis, Michael R. Henry, Diva R. Salomao, Peter Lee, Stephanie K Carlson, Amy C. Clayton

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Transthoracic fine needle aspiration (TFNA)/core needle biopsy (CNB) under computed tomography (CT) guidance has proved useful in the assessment of pulmonary nodules. We sought to determine the TFNA false-negative (FN) rate at our institution and identify potential causes of FN diagnoses. Medical records were reviewed from 1,043 consecutive patients who underwent CT-guided TFNA with or without CNB of lung nodules over a 5-year time period (2003-2007). Thirty-seven FN cases of "negative" TFNA/CNB with malignant outcome were identified with 36 cases available for review, of which 35 had a corresponding CNB. Cases were reviewed independently (blinded to original diagnosis) by three pathologists with 15 age- and sexmatched positive and negative controls. Diagnosis (i.e., nondiagnostic, negative or positive for malignancy, atypical or suspicious) and qualitative assessments were recorded. Consensus diagnosis was suspicious or positive in 10 (28%) of 36 TFNA cases and suspicious in 1 (3%) of 35 CNB cases, indicating potential interpretive errors. Of the 11 interpretive errors (including both suspicious and positive cases), 8 were adenocarcinomas, 1 squamous cell carcinoma, 1 metastatic renal cell carcinoma, and 1 lymphoma. The remaining 25 FN cases (69.4%) were considered sampling errors and consisted of 7 adenocarcinomas, 3 nonsmall cell carcinomas, 3 lymphomas, 2 squamous cell carcinomas, and 2 renal cell carcinomas. Interpretive and sampling error cases were more likely to abut the pleura, while histopathologically, they tended to be necrotic and air-dried. The overall FN rate in this patient cohort is 3.5% (1.1% interpretive and 2.4% sampling errors).

Original languageEnglish (US)
Pages (from-to)1063-1068
Number of pages6
JournalDiagnostic Cytopathology
Volume42
Issue number12
DOIs
StatePublished - Dec 1 2014

Fingerprint

Large-Core Needle Biopsy
Fine Needle Biopsy
Selection Bias
Squamous Cell Carcinoma
Lymphoma
Adenocarcinoma
Tomography
Lung
Pleura
Renal Cell Carcinoma
Medical Records
Air
Carcinoma
Neoplasms

Keywords

  • Computed tomography
  • Cytopathology
  • Diagnosis
  • Lung
  • Neoplasm

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Minot, D. M., Gilman, E. A., Aubry, M. C., Voss, J. S., Van Epps, S. G., Tuve, D. J., ... Clayton, A. C. (2014). An investigation into false-negative transthoracic fine needle aspiration and core biopsy specimens. Diagnostic Cytopathology, 42(12), 1063-1068. https://doi.org/10.1002/dc.23169

An investigation into false-negative transthoracic fine needle aspiration and core biopsy specimens. / Minot, Douglas M.; Gilman, Elizabeth A.; Aubry, Marie Christine; Voss, Jesse S.; Van Epps, Sarah G.; Tuve, Delores J.; Sciallis, Andrew P.; Henry, Michael R.; Salomao, Diva R.; Lee, Peter; Carlson, Stephanie K; Clayton, Amy C.

In: Diagnostic Cytopathology, Vol. 42, No. 12, 01.12.2014, p. 1063-1068.

Research output: Contribution to journalArticle

Minot, DM, Gilman, EA, Aubry, MC, Voss, JS, Van Epps, SG, Tuve, DJ, Sciallis, AP, Henry, MR, Salomao, DR, Lee, P, Carlson, SK & Clayton, AC 2014, 'An investigation into false-negative transthoracic fine needle aspiration and core biopsy specimens', Diagnostic Cytopathology, vol. 42, no. 12, pp. 1063-1068. https://doi.org/10.1002/dc.23169
Minot, Douglas M. ; Gilman, Elizabeth A. ; Aubry, Marie Christine ; Voss, Jesse S. ; Van Epps, Sarah G. ; Tuve, Delores J. ; Sciallis, Andrew P. ; Henry, Michael R. ; Salomao, Diva R. ; Lee, Peter ; Carlson, Stephanie K ; Clayton, Amy C. / An investigation into false-negative transthoracic fine needle aspiration and core biopsy specimens. In: Diagnostic Cytopathology. 2014 ; Vol. 42, No. 12. pp. 1063-1068.
@article{f24df61b81e24386a178df874a7dcb75,
title = "An investigation into false-negative transthoracic fine needle aspiration and core biopsy specimens",
abstract = "Transthoracic fine needle aspiration (TFNA)/core needle biopsy (CNB) under computed tomography (CT) guidance has proved useful in the assessment of pulmonary nodules. We sought to determine the TFNA false-negative (FN) rate at our institution and identify potential causes of FN diagnoses. Medical records were reviewed from 1,043 consecutive patients who underwent CT-guided TFNA with or without CNB of lung nodules over a 5-year time period (2003-2007). Thirty-seven FN cases of {"}negative{"} TFNA/CNB with malignant outcome were identified with 36 cases available for review, of which 35 had a corresponding CNB. Cases were reviewed independently (blinded to original diagnosis) by three pathologists with 15 age- and sexmatched positive and negative controls. Diagnosis (i.e., nondiagnostic, negative or positive for malignancy, atypical or suspicious) and qualitative assessments were recorded. Consensus diagnosis was suspicious or positive in 10 (28{\%}) of 36 TFNA cases and suspicious in 1 (3{\%}) of 35 CNB cases, indicating potential interpretive errors. Of the 11 interpretive errors (including both suspicious and positive cases), 8 were adenocarcinomas, 1 squamous cell carcinoma, 1 metastatic renal cell carcinoma, and 1 lymphoma. The remaining 25 FN cases (69.4{\%}) were considered sampling errors and consisted of 7 adenocarcinomas, 3 nonsmall cell carcinomas, 3 lymphomas, 2 squamous cell carcinomas, and 2 renal cell carcinomas. Interpretive and sampling error cases were more likely to abut the pleura, while histopathologically, they tended to be necrotic and air-dried. The overall FN rate in this patient cohort is 3.5{\%} (1.1{\%} interpretive and 2.4{\%} sampling errors).",
keywords = "Computed tomography, Cytopathology, Diagnosis, Lung, Neoplasm",
author = "Minot, {Douglas M.} and Gilman, {Elizabeth A.} and Aubry, {Marie Christine} and Voss, {Jesse S.} and {Van Epps}, {Sarah G.} and Tuve, {Delores J.} and Sciallis, {Andrew P.} and Henry, {Michael R.} and Salomao, {Diva R.} and Peter Lee and Carlson, {Stephanie K} and Clayton, {Amy C.}",
year = "2014",
month = "12",
day = "1",
doi = "10.1002/dc.23169",
language = "English (US)",
volume = "42",
pages = "1063--1068",
journal = "Diagnostic Cytopathology",
issn = "8755-1039",
publisher = "Wiley-Liss Inc.",
number = "12",

}

TY - JOUR

T1 - An investigation into false-negative transthoracic fine needle aspiration and core biopsy specimens

AU - Minot, Douglas M.

AU - Gilman, Elizabeth A.

AU - Aubry, Marie Christine

AU - Voss, Jesse S.

AU - Van Epps, Sarah G.

AU - Tuve, Delores J.

AU - Sciallis, Andrew P.

AU - Henry, Michael R.

AU - Salomao, Diva R.

AU - Lee, Peter

AU - Carlson, Stephanie K

AU - Clayton, Amy C.

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Transthoracic fine needle aspiration (TFNA)/core needle biopsy (CNB) under computed tomography (CT) guidance has proved useful in the assessment of pulmonary nodules. We sought to determine the TFNA false-negative (FN) rate at our institution and identify potential causes of FN diagnoses. Medical records were reviewed from 1,043 consecutive patients who underwent CT-guided TFNA with or without CNB of lung nodules over a 5-year time period (2003-2007). Thirty-seven FN cases of "negative" TFNA/CNB with malignant outcome were identified with 36 cases available for review, of which 35 had a corresponding CNB. Cases were reviewed independently (blinded to original diagnosis) by three pathologists with 15 age- and sexmatched positive and negative controls. Diagnosis (i.e., nondiagnostic, negative or positive for malignancy, atypical or suspicious) and qualitative assessments were recorded. Consensus diagnosis was suspicious or positive in 10 (28%) of 36 TFNA cases and suspicious in 1 (3%) of 35 CNB cases, indicating potential interpretive errors. Of the 11 interpretive errors (including both suspicious and positive cases), 8 were adenocarcinomas, 1 squamous cell carcinoma, 1 metastatic renal cell carcinoma, and 1 lymphoma. The remaining 25 FN cases (69.4%) were considered sampling errors and consisted of 7 adenocarcinomas, 3 nonsmall cell carcinomas, 3 lymphomas, 2 squamous cell carcinomas, and 2 renal cell carcinomas. Interpretive and sampling error cases were more likely to abut the pleura, while histopathologically, they tended to be necrotic and air-dried. The overall FN rate in this patient cohort is 3.5% (1.1% interpretive and 2.4% sampling errors).

AB - Transthoracic fine needle aspiration (TFNA)/core needle biopsy (CNB) under computed tomography (CT) guidance has proved useful in the assessment of pulmonary nodules. We sought to determine the TFNA false-negative (FN) rate at our institution and identify potential causes of FN diagnoses. Medical records were reviewed from 1,043 consecutive patients who underwent CT-guided TFNA with or without CNB of lung nodules over a 5-year time period (2003-2007). Thirty-seven FN cases of "negative" TFNA/CNB with malignant outcome were identified with 36 cases available for review, of which 35 had a corresponding CNB. Cases were reviewed independently (blinded to original diagnosis) by three pathologists with 15 age- and sexmatched positive and negative controls. Diagnosis (i.e., nondiagnostic, negative or positive for malignancy, atypical or suspicious) and qualitative assessments were recorded. Consensus diagnosis was suspicious or positive in 10 (28%) of 36 TFNA cases and suspicious in 1 (3%) of 35 CNB cases, indicating potential interpretive errors. Of the 11 interpretive errors (including both suspicious and positive cases), 8 were adenocarcinomas, 1 squamous cell carcinoma, 1 metastatic renal cell carcinoma, and 1 lymphoma. The remaining 25 FN cases (69.4%) were considered sampling errors and consisted of 7 adenocarcinomas, 3 nonsmall cell carcinomas, 3 lymphomas, 2 squamous cell carcinomas, and 2 renal cell carcinomas. Interpretive and sampling error cases were more likely to abut the pleura, while histopathologically, they tended to be necrotic and air-dried. The overall FN rate in this patient cohort is 3.5% (1.1% interpretive and 2.4% sampling errors).

KW - Computed tomography

KW - Cytopathology

KW - Diagnosis

KW - Lung

KW - Neoplasm

UR - http://www.scopus.com/inward/record.url?scp=84911401714&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84911401714&partnerID=8YFLogxK

U2 - 10.1002/dc.23169

DO - 10.1002/dc.23169

M3 - Article

C2 - 24866385

AN - SCOPUS:84911401714

VL - 42

SP - 1063

EP - 1068

JO - Diagnostic Cytopathology

JF - Diagnostic Cytopathology

SN - 8755-1039

IS - 12

ER -