RESUMEN
CONTEXT.: Cytologic-histologic correlation (CHC) is a Clinical Laboratory Improvement Amendments-mandated requirement for gynecologic cytology, but no similar requirement exists for nongynecologic cytology. This study presents the findings from a College of American Pathologists' survey of nongynecologic cytology practice patterns. OBJECTIVE.: To survey the current CHC practices for nongynecologic cytology. DESIGN.: Data were analyzed from a survey developed by the committee and distributed to participants in the Nongynecologic Cytopathology Education Program mailing. RESULTS.: Adoption of CHC for nongynecologic cytology cases is worldwide, with 88.5% of institutions performing CHC on these specimens, a substantial increase from previous years. Performance of CHC varied by institution type, with clinic or regional/local independent laboratories and national/corporate laboratories performing CHC significantly less frequently than hospitals, university hospitals/academic medical centers, and Veterans Administration/Department of Defense hospital institutions. Most CHC was performed concurrently in real time, when the corresponding surgical specimen was reviewed. Selection for real-time concurrent CHC was by the interpreting pathologist, the pathologist diagnosing the surgical biopsy sample or cytopathology case, or both. Sampling was by far the most common reason for discordance. A 2-step difference was the most frequent threshold for discordance between cytology and surgical specimens, but this criterion varied among institutions, with no majority definition. The positive predictive value of a positive cytology finding was calculated rarely in North American institutions but was calculated more frequently in international institutions. CONCLUSIONS.: CHC practices for nongynecologic cytopathology mirror those found for CHC of gynecologic cytopathology.
RESUMEN
This is a personal story about the implementation and building of an independent outpatient fine needle aspiration biopsy (FNA) clinic. The story spans 30-years. The clinic was opened in 1991 and for the first five-years, FNA biopsies were done by palpation. In 1996, I began doing biopsies using ultrasound guidance without the assistance of a radiologist, ultrasound technician or imaging center. In this short story, some of my trials and tribulations as well as successes are highlighted.
