Display options
Share it on

BMC Pulm Med. 2003 Sep 08;3:2. doi: 10.1186/1471-2466-3-2.

Diagnostic pitfalls in fine needle aspiration of solitary pulmonary nodules: two cases with radio-cyto-histological correlation.

BMC pulmonary medicine

Bahman Torkian, Rani Kanthan, Brent Burbridge

Affiliations

  1. Department of Pathology, Room 2868, G Wing, Royal University Hospital, Saskatoon, Saskatchewan, S7N OW8, CANADA. [email protected]

PMID: 12962550 PMCID: PMC201022 DOI: 10.1186/1471-2466-3-2

Abstract

BACKGROUND: Fine needle aspiration is an important tool for diagnosis and preoperative evaluation of solitary nodules of the lung. It provides a definitive diagnosis in most patients at low cost with minimal trauma. However, because of the nature of the study and the presentation of the cells in a more distorted and incomplete tissue structure than a histological slide, false positive results can occur. Prior detailed clinical knowledge about the patient, procedures and methods of radiology in obtaining the aspirate specimen is extremely useful in the accurate interpretation of fine needle cytological specimens.

CASE PRESENTATION: We report two cases of solitary pulmonary nodules in two elderly females, which were initially diagnosed as malignant by fine needle aspiration biopsy. Both cases subsequently underwent pulmonary lobectomy in which, one turned out to be a pulmonary hamartoma and the other appeared to be a middle lobe syndrome of the right lung with liver tissue contamination at the time of fine needle aspiration of the lung.

CONCLUSIONS: We are now strong believers that much care must be taken in the interpretation of fine needle aspiration of solitary nodules of the lung. Complete study of the entire specimen, including the cell block, is warranted, since what one interprets as malignant, could have different features in another part of the sample. Last but not the least, prior knowledge of the complete clinical history of the patient together with the salient radiological findings would greatly facilitate the cytopathologist to reach an accurate diagnosis.

References

  1. AJR Am J Roentgenol. 1982 Jan;138(1):65-9 - PubMed
  2. Clin Chest Med. 1993 Mar;14(1):111-9 - PubMed
  3. Ann Thorac Surg. 1977 Nov;24(5):474-80 - PubMed
  4. Acta Cytol. 1999 Jul-Aug;43(4):601-4 - PubMed
  5. AJR Am J Roentgenol. 1998 Feb;170(2):329-31 - PubMed
  6. J Cardiovasc Surg (Torino). 2001 Apr;42(2):271-3 - PubMed
  7. Acta Cytol. 2001 Mar-Apr;45(2):267-70 - PubMed
  8. Diagn Cytopathol. 1989;5(2):174-80 - PubMed
  9. Clin Chest Med. 1992 Mar;13(1):83-95 - PubMed

Publication Types