Group B:
Cytopathologist onsite evaluation n=68 (27%)
Knowledge by the otolaryngologist of the potential for misdiagnosis on FNA sampling should prompt communication with the
cytopathologist when the diagnosis is a consideration.
An endocrinologist performed all samplings, and the cytologic smears were interpreted by a single
cytopathologist.
All slides were examined at the Institute of Pathology, Cantonal Hospital Lucerne, by one trained
cytopathologist blinded as to the origin of the sample.
Consultant
cytopathologist at the Royal Liverpool Hospital Dr Lesley Turnbull said: ``With the traditional test, 10pcof the results are inadequate,meaning the procedure has to be repeated.
Specimens collected from inguinal lymph nodes by fine needle aspiration were submitted to a commercial laboratory for evaluation by a
cytopathologist. Peripheral blood smears and lymph node aspirates were stained with a Wrights-Giemsa stain and evaluated by light microscopy.
Subsequently, a
cytopathologist can play a key role on the diagnostic team.
Smaller diameter needles with improved tissue-cutting features allow multiple passes into a lesion with minimal complications and retrieval of quantities of lesion material sufficient for both histologic and cytologic evaluations.[21] In addition, the diagnostic quality of aspirated specimens has improved with inclusion of a cytotechnologist or
cytopathologist on the IGPNB team.
Urine cytology has historically had the problems of a low sensitivity for well-differentiated tumors and requirement of an experienced
cytopathologist for diagnosis.
Whatever the facts of this particular failure of diagnosis, a psychological analysis of the task facing a
cytopathologist engaged in the classification of cervical smears, and of the procedures at present adopted, indicates that this episode was an accident waiting to happen.
Kyto Diagnostics of New City, New York, a large private lab run by a prominent
cytopathologist, Ralph Richart, reported average workloads of 35,000 cases per screener last year--nearly three times what the cytology society thinks is safe.
Interobserver Variability Using the 6-Tier Classification System
Cytopathologist B
Cytopathologist A I II III IV V VI Total I 0 0 0 0 0 0 0 II 0 12 0 1 0 0 13 III 0 0 0 2 0 0 2 IV 0 0 0 27 0 0 27 V 0 0 0 0 3 1 4 VI 0 0 0 0 0 11 11 Total 0 12 0 30 3 12 57 Table 6.