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A Journal on Internal Medicine

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Minerva Medica 2007 August;98(4):395-400

language: Italian

On-site evaluation and triage for endoscopic ultrasound-guided fine needle aspiration cytology. The Turin experience

Campisi P. 1, Accinelli G. 1, De Angelis C. 2, Pacchioni D. 1, Bussolati G. 1

1 Dipartimento di Scienze Biomediche e Oncologia Università degli Studi di Torino,Torino
2 Dipartimento di Gastroenterologia ed Epatologia Università degli Studi di Torino,Torino


Aim. Evaluation of the importance of the on-site presence of a skilled cytopathologist during endoscopic ultrasound-guided fine needle aspiration at determining samples’ adequacy and performing ancillary techniques which can be helpful for the diagnosis.
Methods. A retrospective analysis of our institute’s experience with EUS-FNA sampling is presented. From January 2001 to May 2007, 404 patients underwent the EUS-FNA evaluation. From 2003 a cytopathologist was present during the procedure and started making an extemporary evaluation of the samples’ adequacy.
Results. Before 2003, a final cytological diagnosis was available in only 70% of the cases (without an on-site cytopathologist). After 2003, in 90% of the cases (with an on-site cytopathologist). It is possible planning and performing: immunocytochemistry on cell block material including evaluation of the proliferation index; to obtain a sample for the flow cytometry in cases of lymphomas or a microbiologic workup in cases of infective lesions.
Conclusion. The quality of the specimens and the proper handling of the aspirated sample are very important to succesfully obtain a definitive cytological diagnosis in EUS-FNA. On-site evaluation and triage of the material allow to improve the accuracy of the diagnosis.

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