PURPOSE: The recommendations for specimen handling using a histology needle for transbronchial needle aspiration (TBNA) are: retrieval of the tissue core (TC), needle flush (NF) into a separate medium, and / or creating slides. In theory, if the TC and NF are collectively pooled into one vial of preservative (TC-NF), and slides are prepared simultaneously with each needle pass, then the overall yield of the procedure should not differ from the yields of the two specimens separately. We investigated whether our experience of submitting collectively pooled TC-NF and slides together has a higher yield than if each specimen were submitted separately.
METHODS: 37 patients underwent diagnostic TBNA using a MW-319 histology needle. A TC was first transferred into preservative, a slide was then prepared using smear technique, followed by a NF into the preservative containing the core, TC-NF, for each pass of the needle. The TC-NF was collectively pooled from each needle pass. Data were analyzed to determine the yield of the combined specimens TC-NF + slides versus the yield if submitted separately TC-NF or slides.
RESULTS: The overall diagnostic yield was 83.8%, with separate yields of 67.6% and 64.9% for the TC-NF and slides, respectively. In only 48.6% were both the TC-NF and the slides diagnostic. In 18.9%, only the TC-NF was diagnostic compared to14.7% for the slides (p = .189). At our institution there was no additional cost for submitting both specimens. There were no adverse events associated with the procedures.
CONCLUSION: In our experience, submitting TC-NF + slides has a significantly higher yield than if each had been submitted separately (p < .001). Furthermore, there were no additional risks, complications, or costs afforded to the patients.
CLINICAL IMPLICATIONS: Endoscopists performing TBNA should not underestimate the importance of submitting a pooled TC-NF cell block in combination with cytology slides in an effort to improve their diagnostic yield.
DISCLOSURE: Eric Flenaugh, None.