Rapid On-Site Evaluation has High Diagnostic Yield Differentiating Adenocarcinoma vs Squamous Cell Carcinoma of Non–Small Cell Lung Carcinoma, not Otherwise Specified Subgroup

Betul Celik, Andras Khoor, Tangul Bulut, Aziza Nassar

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7 Citations (Scopus)

Abstract

Our objective was to evaluate the diagnostic yield of rapid on-site evaluation (ROSE) on the differential diagnosis of non–small cell lung carcinoma, not otherwise specified (NSCLC-NOS). Biopsied cases diagnosed as NSCLC-NOS with ROSE during 2004 through 2008 were retrieved. Diagnostic confirmation was done with immunohistochemistry (IHC) involving thyroid transcription factor-1 and p63 immunostains. For the study, 106 cases were available. The final diagnoses rendered were squamous cell carcinoma (SqCC) (n = 39) and adenocarcinoma (AC) (n = 67). Cytologic, histologic, and IHC concordance for these diagnoses occurred in 75 cases (70.8 %), of which 56 (52.8 %) were AC and 19 (17.9 %) were SqCC. Cytologic, histologic, and IHC discordance was found in 31 cases (29.2 %). Of these 31 cases, 11 NSCLC-NOS diagnoses histologically corresponded to 1 SqCC plus 4 ACs, and 4 favor SqCC plus 2 ACs; the former 5 NSCLC-NOS cases classified correctly through cytology, as well as IHC. However, IHC was not available for the latter 6 NSCLC-NOS cases that were also classified correctly through cytology. In addition, only 3 NSCLC-NOS diagnoses cytologically corresponded to 3 favor SqCC histologically, in which IHC was not available, and for 2 cases that both corresponded to favor SqCC and favor AC histologically and cytologically. In the other 15 cases, histology labeled 4 cases NSCLC-NOS and misclassified 2 cases; cytology labeled 1 case NSCLC-NOS and misclassified 13 cases. ROSE has high diagnostic yield over subclassification of NSCLC-NOS. We recommend allocating a cytotechnologist for specimen adequacy and a cytopathologist for cytologic diagnosis.

Original languageEnglish (US)
Pages (from-to)167-172
Number of pages6
JournalPathology and Oncology Research
Volume21
Issue number1
DOIs
StatePublished - 2015

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Squamous Cell Carcinoma
Adenocarcinoma
Carcinoma
Lung
Immunohistochemistry
Cell Biology
Histology
Differential Diagnosis

Keywords

  • Cytology
  • Lung carcinoma
  • Non–small cell lung carcinoma
  • On-site cytologic evaluation
  • Subclassification

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pathology and Forensic Medicine

Cite this

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title = "Rapid On-Site Evaluation has High Diagnostic Yield Differentiating Adenocarcinoma vs Squamous Cell Carcinoma of Non–Small Cell Lung Carcinoma, not Otherwise Specified Subgroup",
abstract = "Our objective was to evaluate the diagnostic yield of rapid on-site evaluation (ROSE) on the differential diagnosis of non–small cell lung carcinoma, not otherwise specified (NSCLC-NOS). Biopsied cases diagnosed as NSCLC-NOS with ROSE during 2004 through 2008 were retrieved. Diagnostic confirmation was done with immunohistochemistry (IHC) involving thyroid transcription factor-1 and p63 immunostains. For the study, 106 cases were available. The final diagnoses rendered were squamous cell carcinoma (SqCC) (n = 39) and adenocarcinoma (AC) (n = 67). Cytologic, histologic, and IHC concordance for these diagnoses occurred in 75 cases (70.8 {\%}), of which 56 (52.8 {\%}) were AC and 19 (17.9 {\%}) were SqCC. Cytologic, histologic, and IHC discordance was found in 31 cases (29.2 {\%}). Of these 31 cases, 11 NSCLC-NOS diagnoses histologically corresponded to 1 SqCC plus 4 ACs, and 4 favor SqCC plus 2 ACs; the former 5 NSCLC-NOS cases classified correctly through cytology, as well as IHC. However, IHC was not available for the latter 6 NSCLC-NOS cases that were also classified correctly through cytology. In addition, only 3 NSCLC-NOS diagnoses cytologically corresponded to 3 favor SqCC histologically, in which IHC was not available, and for 2 cases that both corresponded to favor SqCC and favor AC histologically and cytologically. In the other 15 cases, histology labeled 4 cases NSCLC-NOS and misclassified 2 cases; cytology labeled 1 case NSCLC-NOS and misclassified 13 cases. ROSE has high diagnostic yield over subclassification of NSCLC-NOS. We recommend allocating a cytotechnologist for specimen adequacy and a cytopathologist for cytologic diagnosis.",
keywords = "Cytology, Lung carcinoma, Non–small cell lung carcinoma, On-site cytologic evaluation, Subclassification",
author = "Betul Celik and Andras Khoor and Tangul Bulut and Aziza Nassar",
year = "2015",
doi = "10.1007/s12253-014-9802-x",
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T1 - Rapid On-Site Evaluation has High Diagnostic Yield Differentiating Adenocarcinoma vs Squamous Cell Carcinoma of Non–Small Cell Lung Carcinoma, not Otherwise Specified Subgroup

AU - Celik, Betul

AU - Khoor, Andras

AU - Bulut, Tangul

AU - Nassar, Aziza

PY - 2015

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N2 - Our objective was to evaluate the diagnostic yield of rapid on-site evaluation (ROSE) on the differential diagnosis of non–small cell lung carcinoma, not otherwise specified (NSCLC-NOS). Biopsied cases diagnosed as NSCLC-NOS with ROSE during 2004 through 2008 were retrieved. Diagnostic confirmation was done with immunohistochemistry (IHC) involving thyroid transcription factor-1 and p63 immunostains. For the study, 106 cases were available. The final diagnoses rendered were squamous cell carcinoma (SqCC) (n = 39) and adenocarcinoma (AC) (n = 67). Cytologic, histologic, and IHC concordance for these diagnoses occurred in 75 cases (70.8 %), of which 56 (52.8 %) were AC and 19 (17.9 %) were SqCC. Cytologic, histologic, and IHC discordance was found in 31 cases (29.2 %). Of these 31 cases, 11 NSCLC-NOS diagnoses histologically corresponded to 1 SqCC plus 4 ACs, and 4 favor SqCC plus 2 ACs; the former 5 NSCLC-NOS cases classified correctly through cytology, as well as IHC. However, IHC was not available for the latter 6 NSCLC-NOS cases that were also classified correctly through cytology. In addition, only 3 NSCLC-NOS diagnoses cytologically corresponded to 3 favor SqCC histologically, in which IHC was not available, and for 2 cases that both corresponded to favor SqCC and favor AC histologically and cytologically. In the other 15 cases, histology labeled 4 cases NSCLC-NOS and misclassified 2 cases; cytology labeled 1 case NSCLC-NOS and misclassified 13 cases. ROSE has high diagnostic yield over subclassification of NSCLC-NOS. We recommend allocating a cytotechnologist for specimen adequacy and a cytopathologist for cytologic diagnosis.

AB - Our objective was to evaluate the diagnostic yield of rapid on-site evaluation (ROSE) on the differential diagnosis of non–small cell lung carcinoma, not otherwise specified (NSCLC-NOS). Biopsied cases diagnosed as NSCLC-NOS with ROSE during 2004 through 2008 were retrieved. Diagnostic confirmation was done with immunohistochemistry (IHC) involving thyroid transcription factor-1 and p63 immunostains. For the study, 106 cases were available. The final diagnoses rendered were squamous cell carcinoma (SqCC) (n = 39) and adenocarcinoma (AC) (n = 67). Cytologic, histologic, and IHC concordance for these diagnoses occurred in 75 cases (70.8 %), of which 56 (52.8 %) were AC and 19 (17.9 %) were SqCC. Cytologic, histologic, and IHC discordance was found in 31 cases (29.2 %). Of these 31 cases, 11 NSCLC-NOS diagnoses histologically corresponded to 1 SqCC plus 4 ACs, and 4 favor SqCC plus 2 ACs; the former 5 NSCLC-NOS cases classified correctly through cytology, as well as IHC. However, IHC was not available for the latter 6 NSCLC-NOS cases that were also classified correctly through cytology. In addition, only 3 NSCLC-NOS diagnoses cytologically corresponded to 3 favor SqCC histologically, in which IHC was not available, and for 2 cases that both corresponded to favor SqCC and favor AC histologically and cytologically. In the other 15 cases, histology labeled 4 cases NSCLC-NOS and misclassified 2 cases; cytology labeled 1 case NSCLC-NOS and misclassified 13 cases. ROSE has high diagnostic yield over subclassification of NSCLC-NOS. We recommend allocating a cytotechnologist for specimen adequacy and a cytopathologist for cytologic diagnosis.

KW - Cytology

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KW - Non–small cell lung carcinoma

KW - On-site cytologic evaluation

KW - Subclassification

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