Fine-needle aspiration biopsy of bronchioloalveolar carcinoma

Citation
Ll. Macdonald et Hm. Yazdi, Fine-needle aspiration biopsy of bronchioloalveolar carcinoma, CANC CYTOP, 93(1), 2001, pp. 29-34
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
CANCER CYTOPATHOLOGY
ISSN journal
0008-543X → ACNP
Volume
93
Issue
1
Year of publication
2001
Pages
29 - 34
Database
ISI
SICI code
0008-543X(20010225)93:1<29:FABOBC>2.0.ZU;2-1
Abstract
BACKGROUND. The purpose of the current study was to determine the accuracy of the cytologic diagnosis of bronchioloalveolar carcinoma (BAC) by fine-ne edle aspiration biopsy (FNAB). METHODS. During a 4-year period (1994-1998), 1664 lung FNABs were performed . Forty-nine patients with BAC diagnosed by FNAB and/or surgical biopsy for med the basis of this study. RESULTS. Twenty-four patients diagnosed with BAC by FNAB had histologic con firmation. Surgical pathology revealed BAC in 15 patients with a cytologic diagnosis of large cell carcinoma (LCA) or adenocarcinoma (ACA). Nine patie nts diagnosed with BAC by FNAB were found to have ACA histologically. One u nsatisfactory aspirate was diagnosed as BAC by surgical pathology. Review o f 15 FNAB specimens with a diagnosis of LCA or ACA revealed cytologic featu res typical of BAG. In six aspirates, additional features such as pronounce d nuclear crowding and overlapping, variation in nuclear size, and increase d number of pleomorphic cells interfered with the FNAB diagnosis of BAG. Ni ne FNABs with a diagnosis of BAC were found histologically to have ACA with a focal BAC growth pattern. One unsatisfactory FNAB aspirate diagnosed as BAC histologically was due to sampling error. CONCLUSIONS. A diagnosis of BAC by FNAB is possible using conventional cyto logic criteria. Some BACs show pronounced nuclear crowding and overlapping, variation in nuclear size, and an increased number of pleomorphic cells cy tologically, which may interfere with an FNAB diagnosis of BAG. FNABs from ACA cases with a focal BAC pattern remain a diagnostic dilemma due to the n ature of the lesion. In addition, sampling error by FNAB can be a diagnosti c pitfall. Cancer (Cancer Cytopathol) 2001;93:29-34. (C) 2001 American Canc er Society.