{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T16:59:38Z","timestamp":1763744378427,"version":"3.45.0"},"reference-count":34,"publisher":"BMJ","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1996,10]]},"abstract":"<jats:p>AIMS: To assess the value of immediate assessment of cytology in percutaneous fine needle aspiration (FNA) cytology of lung. METHODS: FNA specimens from 75 consecutive patients with suspected pulmonary neoplasms were subjected to immediate cytology assessment. Direct smears were prepared in the radiology department and stained using the Diff Quik method. The cellular content was assessed and, if possible, a provisional diagnosis offered. A second FNA was requested if the initial aspirate seemed of doubtful adequacy. The diagnostic accuracy was examined by review of clinical and radiological data in all patients, and by correlation with other histological or cytological material in 25 patients. Complications of the procedure were identified during the clinical review. RESULTS: Two of 75 specimens were inadequate for diagnosis. Satisfactory diagnostic material was obtained in 51 patients on a single aspirate and following a second FNA in 22 patients. Of the 73 satisfactory aspirates, 58 were malignant, one highly suspicious of malignancy and 14 reported as negative for malignancy. All malignant diagnoses were confirmed on clinical or pathological review. FNA accurately distinguished primary small cell and large cell carcinomas in those patients with pathological follow up. There were two false negative reports, one due to sampling error and the other due to misinterpretation of aspirate material. The diagnostic specificity was 100% and sensitivity 96.6%. Complications were recorded in seven (9.3%) patients, five of whom developed pneumothorax; a chest drain was required in one patient. CONCLUSIONS: Percutaneous FNA cytology provides safe and accurate diagnosis in the investigation of pulmonary lesions. Immediate cytology assessment ensures that aspirate material is handled optimally, and those patients requiring further sampling or ancillary investigation identified rapidly. The number of unsatisfactory and false negative lung FNA are therefore reduced. The complication rate is minimised by decreasing the number of pleural punctures.<\/jats:p>","DOI":"10.1136\/jcp.49.10.839","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"839-843","source":"Crossref","is-referenced-by-count":50,"title":["Immediate assessment of fine needle aspiration cytology of lung."],"prefix":"10.1136","volume":"49","author":[{"given":"C J","family":"Stewart","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I S","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1996,10,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0272-5231(21)01151-5","article-title":"The role of transthoracic needle biopsy for the diagnosis and staging of lung cancer","volume":"14","author":"Salazar, A.M.; Westcott, J.L.","year":"1993","unstructured":"Salazar AM, Westcott JL. The role of transthoracic needle biopsy for the diagnosis and staging of lung cancer. Clin Chest Med 1993;14:99-110.","journal-title":"Clin Chest Med"},{"key":"ref_2","first-page":"647","article-title":"Transthoracic percutaneous lung biopsy","volume":"28","author":"Weisbrod, G.L.","year":"1990","unstructured":"Weisbrod GL. Transthoracic percutaneous lung biopsy. Radiol Clin North Am 1990;28:647-55.","journal-title":"Radiol Clin North Am"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0272-5231(21)00832-7","article-title":"Transthoracic needle aspiration","volume":"13","author":"Sanders, C.","year":"1992","unstructured":"Sanders C. Transthoracic needle aspiration. Clin Chest Med 1992;13:1-16.","journal-title":"Clin Chest Med"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1002\/dc.2840020402","article-title":"Value and limitations of transthoracic and transabdominal fine-needle aspiration cytology in clinical practice","volume":"2","author":"Tao, L.C.; Sanders, D.E.; Weisbrod, G.L.; Ho, C.S.; Wilson, S.","year":"1986","unstructured":"Tao LC, Sanders DE, Weisbrod GL, Ho CS, Wilson S. Value and limitations of transthoracic and transabdominal fine-needle aspiration cytology in clinical practice. Diagn Cytopathol 1986;2:271-6.","journal-title":"Diagn Cytopathol"},{"key":"ref_5","first-page":"197","article-title":"Fine-needle aspiration of lung, mediastinum, and chest wall. A clinicopathologic exercise","volume":"17","author":"Sterrett, G.; Whitaker, D.; Glancy, J.","year":"1982","unstructured":"Sterrett G, Whitaker D, Glancy J. Fine-needle aspiration of lung, mediastinum, and chest wall. A clinicopathologic exercise. PatholAnnu 1982;17: 197-228.","journal-title":"PatholAnnu"},{"key":"ref_6","first-page":"463","article-title":"Interinstitutional database for comparison of performance in lung fine-needle aspiration cytology","volume":"116","author":"Zarbo, R.J.; Fenoglio-Preiser, C.M.","year":"1992","unstructured":"Zarbo RJ, Fenoglio-Preiser CM. Interinstitutional database for comparison of performance in lung fine-needle aspiration cytology. Arch Pathol Lab Med 1992;116:463-70.","journal-title":"Arch Pathol Lab Med"},{"key":"ref_7","first-page":"16","article-title":"Causes of false results in transthoracic fine needle aspirates","volume":"37","author":"Cagle, P.T.; Kovach, M.; Ramzy, I.","year":"1993","unstructured":"Cagle PT, Kovach M, Ramzy I. Causes of false results in transthoracic fine needle aspirates. Acta Cytol 1993;37:16-20.","journal-title":"Acta Cytol"},{"key":"ref_8","first-page":"178","article-title":"Rapid screening techniques employed in fine-needle aspirations of the lung","volume":"25","author":"Pak, H.Y.; Yokota, S.; Teplitz, R.L.; Shaw, S.L.; Werner, J.L.","year":"1981","unstructured":"Pak HY, Yokota S, Teplitz RL, Shaw SL, Werner JL. Rapid screening techniques employed in fine-needle aspirations of the lung. Acta Cytol 1981;25:178-84.","journal-title":"Acta Cytol"},{"key":"ref_9","first-page":"791","article-title":"Diagnostic accuracy and role of immediate interpretation of fine-needle aspiration biopsy specimens from various sites","volume":"33","author":"Silverman, J.F.; Finley, J.L.; O'Brien, K.F.; Dabbs, D.J.; Park, H.K.; Larkin, E.W.","year":"1989","unstructured":"Silverman JF, Finley JL, O'Brien KF, Dabbs DJ, Park HK, Larkin EW, et al. Diagnostic accuracy and role of immediate interpretation of fine-needle aspiration biopsy specimens from various sites. Acta Cytol 1989;33:791-6.","journal-title":"Acta Cytol"},{"key":"ref_10","first-page":"813","article-title":"Thoracic needle biopsy. Improved results utilizing a team approach","volume":"91","year":"1987","unstructured":"Conces DJ, Schwenk GR, Doering PR, Glant MD. Thoracic needle biopsy. Improved results utilizing a team approach. Chest 1987;91:813-16.","journal-title":"Chest"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2214\/ajr.160.1.8416620","article-title":"Value of having a cytopathologist present during percutaneous fine-needle aspiration biopsy of lung: report of 55 cancer patients and meta-analysis of the literature","volume":"160","author":"Austin, J.H.; Cohen, M.B.","year":"1993","unstructured":"Austin JH, Cohen MB. Value of having a cytopathologist present during percutaneous fine-needle aspiration biopsy of lung: report of 55 cancer patients and meta-analysis of the literature. AYR Am J Roentgenol 1993; 160: 175-7","journal-title":"AYR Am J Roentgenol"},{"key":"ref_12","first-page":"69","article-title":"Tumours of lung and mediastinum","author":"Sterrett, G.F.; Frost, F.; Whitaker, D.","year":"1995","unstructured":"Sterrett GF, Frost F, Whitaker D. Tumours of lung and mediastinum. In: Gray W, ed. Diagnostic cytopatholgy. Edinburgh: Churchill Livingstone, 1995:69-128."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/S0009-9260(05)82930-7","article-title":"The role of immediate cytological evaluation in CT-guided biopsy","volume":"49","author":"Ward, S.C.; Carey, B.M.; Chalmers, A.G.; Sutton, J.","year":"1994","unstructured":"Ward SC, Carey BM, Chalmers AG, Sutton J. The role of immediate cytological evaluation in CT-guided biopsy. Clin Radiol 1994;49:531-4.","journal-title":"Clin Radiol"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/S0009-9260(05)83438-5","article-title":"The value of immediate cytological evaluation for needle aspiration lung biopsy","volume":"50","author":"Padhani, A.R.; Scott, W.; Cheema, M.; Erozan, Y.S.","year":"1995","unstructured":"Padhani AR, Scott W, Cheema M, Erozan YS. The value of immediate cytological evaluation for needle aspiration lung biopsy. Clin Radiol 1995;50:350-1.","journal-title":"Clin Radiol"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1136\/thx.43.7.540","article-title":"Prospective evaluation of fine needle aspiration in the diagnosis of lung cancer","volume":"43","author":"Veale, D.; Gilmartin, J.J.; Sumerling, M.D.; Wadehra, V.; Gibson, G.J.","year":"1988","unstructured":"Veale D, Gilmartin JJ, Sumerling MD, Wadehra V, Gibson GJ. Prospective evaluation of fine needle aspiration in the diagnosis of lung cancer. Thorax 1988;43:540-4.","journal-title":"Thorax"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"793","DOI":"10.2214\/ajr.144.4.793","article-title":"Rapid cytology to decrease pneumothorax incidence after percutaneous biopsy","volume":"144","author":"Johnsrude, I.S.; Silverman, J.F.; Weaver, M.D.; McConnell, R.W.","year":"1985","unstructured":"Johnsrude IS, Silverman JF, Weaver MD, McConnell RW. Rapid cytology to decrease pneumothorax incidence after percutaneous biopsy. AYR Am J Roentgenol 1985;144:793-4.","journal-title":"AYR Am J Roentgenol"},{"key":"ref_17","first-page":"131","article-title":"Integration of transbronchial and percutaneous approach in the diagnosis of peripheral pulmonary nodules or masses. Experience with 1027 consecutive cases","volume":"108","author":"Gasparini, S.; Ferretti, M.; Secchi, E.B.; Baldelli, S.; Zuccatosta, L.; Gusella, P.","year":"1995","unstructured":"Gasparini S, Ferretti M, Secchi EB, Baldelli S, Zuccatosta L, Gusella P. Integration of transbronchial and percutaneous approach in the diagnosis of peripheral pulmonary nodules or masses. Experience with 1027 consecutive cases. Chest 1995;108:131-7.","journal-title":"Chest"},{"key":"ref_18","first-page":"283","article-title":"Negative predictive value of pulmonary fine needle aspiration cytology","volume":"36","author":"Zakowski, M.F.; Gatscha, R.M.; Zaman, M.B.","year":"1992","unstructured":"Zakowski MF, Gatscha RM, Zaman MB. Negative predictive value of pulmonary fine needle aspiration cytology. Acta Cytol 1992;36:283-6.","journal-title":"Acta Cytol"},{"key":"ref_19","first-page":"504","article-title":"Transthoracic fine-needle aspiration. Experience in a cancer center","volume":"56","author":"Crosby, J.H.; Hager, B.; Hoeg, K.","year":"1985","unstructured":"Crosby JH, Hager B, Hoeg K. Transthoracic fine-needle aspiration. Experience in a cancer center. Cancer 1985;56: 504-7.","journal-title":"Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1002\/dc.2840020404","article-title":"Transthoracic needle biopsy in neoplastic and non-neoplastic pathology: experience in a general hospital","volume":"2","author":"Alonso, P.; Sanchez, S.; Ramirez, E.; Cicero, R.","year":"1986","unstructured":"Alonso P, Sanchez S, Ramirez E, Cicero R. Transthoracic needle biopsy in neoplastic and non-neoplastic pathology: experience in a general hospital. Diagn Cytopathol 1986;2: 284-9.","journal-title":"Diagn Cytopathol"},{"key":"ref_21","first-page":"98","article-title":"Transthoracic aspiration biopsy of pulmonary and mediastinal lesions","volume-title":"Eurj7Radiol","volume":"12","author":"MA, De Gregoria Ariza; ER, Alfonso Aguiran; JL, Villavieja Atance","year":"1991","unstructured":"De Gregoria Ariza MA, Alfonso Aguiran ER, Villavieja Atance JL, et al. Transthoracic aspiration biopsy of pulmonary and mediastinal lesions. Eurj7Radiol 1991;12:98-103."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/S0002-9610(88)80523-3","article-title":"Diagnosis of pulmonary masses by fine-needle aspiration","volume":"156","author":"Lovett, J.V.; Manalo, P.B.; Barcia, T.C.; Bomberger, R.A.; McGregor, D.B.","year":"1988","unstructured":"Lovett JV, Manalo PB, Barcia TC, Bomberger RA, McGregor DB. Diagnosis of pulmonary masses by fine-needle aspiration. Am J Surg 1988;156:441-5.","journal-title":"Am J Surg"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/dc.2840100405","article-title":"Transthoracic fineneedle aspiration biopsy cytology of pulmonary neoplasms","volume":"10","author":"Hayes, M.M.M.; Zhang, D.Y.; Brown, W.","year":"1994","unstructured":"Hayes MMM, Zhang DY, Brown W. Transthoracic fineneedle aspiration biopsy cytology of pulmonary neoplasms. Diagn Cytopathol 1994;10:315-19.","journal-title":"Diagn Cytopathol"},{"key":"ref_24","first-page":"416","article-title":"Fine-needle aspiration biopsy in the diagnosis of intrathoracic masses","volume":"36","author":"Cristallini, E.G.; Ascani, S.; Farabi, R.; Paganelli, C.; Peciarolo, A.; Bolis, G.B.","year":"1992","unstructured":"Cristallini EG, Ascani S, Farabi R, Paganelli C, Peciarolo A, Bolis GB. Fine-needle aspiration biopsy in the diagnosis of intrathoracic masses. Acta Cytol 1992;36:416-22.","journal-title":"Acta Cytol"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1148\/radiology.198.2.8596834","article-title":"Risk of pneumothorax in CT-guided transthoracic needle aspiration biopsy of the lung","volume":"198","author":"Kazerooni, E.A.; Lim, F.T.; Mikhail, A.; Martinez, F.J.","year":"1996","unstructured":"Kazerooni EA, Lim FT, Mikhail A, Martinez FJ. Risk of pneumothorax in CT-guided transthoracic needle aspiration biopsy of the lung. Radiology 1996;198:371-5.","journal-title":"Radiology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1148\/radiology.162.2.3797651","article-title":"Lung lesions: cytologic diagnosis by fine-needle biopsy","volume":"162","author":"Stanley, J.H.; Fish, G.D.; Andriole, J.G.; Gobien, R.P.; Betsill, W.L.; Laden, S.A.","year":"1987","unstructured":"Stanley JH, Fish GD, Andriole JG, Gobien RP, Betsill WL, Laden SA, et al. Lung lesions: cytologic diagnosis by fine-needle biopsy. Radiology 1987;162:389-91.","journal-title":"Radiology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1136\/thx.41.11.875","article-title":"Interpretation of negative results in fine needle aspiration of discrete pulmonary lesions","volume":"41","author":"Winning, A.J.; McIvor, J.; Seed, W.A.; Husain, O.A.N.; Metaxas, N.","year":"1986","unstructured":"Winning AJ, McIvor J, Seed WA, Husain OAN, Metaxas N. Interpretation of negative results in fine needle aspiration of discrete pulmonary lesions. Thorax 1986;41:875-9.","journal-title":"Thorax"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1093\/ajcp\/82.1.100","article-title":"Transthoracic fine-needle aspiration cytology. Analysis of 82 patients with detailed verification criteria and evaluation of false negative cases","volume":"82","author":"Caya, J.G.; Clowry, U.; Wollenberg, N.J.; Tieu, T.M.","year":"1984","unstructured":"Caya JG, Clowry U, Wollenberg NJ, Tieu TM. Transthoracic fine-needle aspiration cytology. Analysis of 82 patients with detailed verification criteria and evaluation of false negative cases. Am J Clin Pathol 1984;82:100-3.","journal-title":"Am J Clin Pathol"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1002\/dc.2840020403","article-title":"Percutaneous fine-needle cytology for lung cancer diagnosis","volume":"2","author":"Kato, H.; Konaka, C.; Kawate, N.; Yoneyama, K.; Nishimiya, K.; Saito, M.","year":"1986","unstructured":"Kato H, Konaka C, Kawate N, Yoneyama K, Nishimiya K, Saito M, et al. Percutaneous fine-needle cytology for lung cancer diagnosis. Diagn Cytopathol 1986;2:277-83.","journal-title":"Diagn Cytopathol"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1002\/1097-0142(19860415)57:8<1565::AID-CNCR2820570821>3.0.CO;2-J","article-title":"Cytologic diagnosis of bronchioloalveolar carcinoma by fine-needle aspiration biopsy","volume":"57","author":"Tao, L.C.; Weisbrod, G.L.; Pearson, F.G.; Sanders, D.E.; Donat, E.E.; Filipetto, L.","year":"1986","unstructured":"Tao LC, Weisbrod GL, Pearson FG, Sanders DE, Donat EE, Filipetto L. Cytologic diagnosis of bronchioloalveolar carcinoma by fine-needle aspiration biopsy. Cancer 1986; 57:1565-70.","journal-title":"Cancer"},{"key":"ref_31","first-page":"717","article-title":"Cytology and immunocytochemistry of bronchiolo-alveolar carcinoma","volume":"31","author":"Lozowski, W.; Hajdu, S.I.","year":"1987","unstructured":"Lozowski W, Hajdu SI. Cytology and immunocytochemistry of bronchiolo-alveolar carcinoma. Acta Cytol 1987;31: 717-25.","journal-title":"Acta Cytol"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1136\/thx.42.12.967","article-title":"Use of percutaneous needle biopsy in the investigation of solitary pulmonary nodules","volume":"42","author":"Penketh, A.R.L.; Robinson, A.A.; Barker, V.; Flower, C.D.R.","year":"1987","unstructured":"Penketh ARL, Robinson AA, Barker V, Flower CDR. Use of percutaneous needle biopsy in the investigation of solitary pulmonary nodules. Thorax 1987;42:967-71.","journal-title":"Thorax"},{"key":"ref_33","first-page":"751","article-title":"Transthoracic needle aspiration. The benign diagnosis","volume":"115","author":"Fraser, R.S.","year":"1991","unstructured":"Fraser RS. Transthoracic needle aspiration. The benign diagnosis. Arch Pathol Lab Med 1991;115:751-61.","journal-title":"Arch Pathol Lab Med"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"281","DOI":"10.2214\/ajr.144.2.281","article-title":"Transthoracic needle aspiration biopsy of benign and malignant lung lesions","volume":"144","author":"Khouri, N.F.; Stitik, F.P.; Erozan, Y.S.; Gupta, P.K.; Kim, W.S.; WW, Jr, Scott","year":"1985","unstructured":"Khouri NF, Stitik FP, Erozan YS, Gupta PK, Kim WS, Scott WW Jr, et al. Transthoracic needle aspiration biopsy of benign and malignant lung lesions. A3rR Am J Roentgenol 1985;144:281-8.","journal-title":"A3rR Am J Roentgenol"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.49.10.839","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T16:55:35Z","timestamp":1763744135000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.49.10.839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,10]]},"references-count":34,"journal-issue":{"issue":"10","published-online":{"date-parts":[[1996,10,1]]},"published-print":{"date-parts":[[1996,10]]}},"alternative-id":["10.1136\/jcp.49.10.839"],"URL":"https:\/\/doi.org\/10.1136\/jcp.49.10.839","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"type":"print","value":"0021-9746"},{"type":"electronic","value":"1472-4146"}],"subject":[],"published":{"date-parts":[[1996,10]]}}}