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Atlas of Fine Needle Aspiration Cytology

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Abstract

Cytological examination of specimens obtained from bronchial tree and lung tissue is a cost-effective, safe, and fast method of diagnosing lung disease. There are many established sampling and preparation techniques, producing cytological specimens for routine microscopic examinations, and a spectrum of ancillary methods such as microbiology, cytochemical, immunocytochemical, and molecular genetic examinations. Procedures such as examination of sputum are focused on lesions affecting the bronchial mucosa, whereas bronchoalveolar lavage (BAL) focuses on distal airways and alveolar mucosa. Via a bronchoscope, samples can be taken directly from larger- or middle-sized branches by aspiration of bronchial secretions, bronchial washing, and brushing. Lesions located beneath the bronchial surface and mediastinal targets such as mediastinal lymph nodes can be sampled by transbronchial fine-needle aspiration (FNA). Pulmonary masses not accessible through the bronchial tree, often peripherally located in the lungs, may be reached by percutaneous transthoracic FNA. The main limitations of FNA include size of the sample and lack of architectural/histologic pattern. Core needle biopsy (CNB) is another minimally invasive procedure commonly used in the evaluation of lung masses. Thus, CNB preserves tissue architecture, it is a slightly more invasive procedure than FNA, and samplings obtained by CNB are of limited size. FNA and CNB often yielded similar diagnostic accuracy for malignant tumors and epithelial malignancies, whereas CNB is slightly superior in the diagnosis of nonepithelial and benign neoplasms and provision of specific histologic diagnosis.

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    Henryk A. Domanski & Anna M. Domanski

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    Nastaran Monsef

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Domanski, H.A., Monsef, N., Domanski, A.M. (2019). Lung. In: Domanski, H. (eds) Atlas of Fine Needle Aspiration Cytology. Springer, Cham. https://doi.org/10.1007/978-3-319-76980-6_7

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