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FALSE NEGATIVE BRONCHIAL CYTOLOGY
Author(s) -
Feeley L.,
Royston D.
Publication year - 2006
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/j.1365-2303.2006.00392_11_3.x
Subject(s) - medicine , cytology , false negative reactions , pathology , malignant cells , radiology , cancer
and Aims: The sensitivity of bronchial cytology (brushings, washings) is in the region of 70–80%. Therefore a significant number of false negatives occur. The main aims of this study were to: (i) To identify negative bronchial washings and brushings performed in 2004 with malignant follow‐up and (ii) To ascertain the cause of the false negative result where possible. 56 patients with negative bronchial cytology and subsequent malignant follow‐up on a pulmonary specimen were identified. These cases formed the basis of the study. Results: In our series peripheral tumour location and specimen inadequacy accounted for the majority of false negative results. Malignant cells were missed in a minority of cases (5 of 56). An explanation for failure of diagnosis in 4 of the 5 cases was paucity of malignant cells. In one case of small cell carcinoma, malignant cells were abundant, but were not recognized. Recommendations: What can be done to reduce the false negative rate? (1) In cases where radiology has indicated that the tumour is peripherally located patients could proceed directly to fine needle aspiration. (2) Improved communication between clinicians and pathologists is required in relation to: (a) specimen adequacy and (b) degree of clinical suspicion.