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Qualitative System for Assessing Cytologic-Histologic Correlation in Non-Gynecologic Cytology Specimens
Fatima Zahra Aly1,2, Donald Shumate3,4, Safiya Nur Khambaty5
1Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA, fatima.aly@wfusm.edu.
Introduction:
Cytologic-histologic correlation (CHC) is a requirement by the Clinical Laboratory Improvement Amendments of 1988 (CLIA) for laboratories that perform cytology-based gynecologic cancer screening. Gynecologic cytology has well-established criteria for performing CHC. To our knowledge, there is limited literature about the implementation of CHC protocols for non-gynecologic specimens such as fine-needle aspirations. Non-gynecologic cytology can provide useful information to clinicians by guiding next steps in management. CHC also provides a secondary utility for assessing staff competencies. The College of American Pathologists requires all laboratories to periodically assess competencies, and to perform proficiency testing to ensure diagnostic accuracy.
Methods:
We developed a system for real-time and/or retrospective CHC to recognize and grade any discordances that arise, and to review the causes of discrepancy. We describe an organ specific (pancreas) system of CHC with scoring of degree of discordance and benchmark setting of acceptable discrepancy for cytotechnologists and cytopathologists.
Results:
Root cause analysis in discordant cases identifies the key issues that impact cytological diagnostic accuracy.
Conclusion:
This model can be utilized by any non-gynecologic cytology system to inform accuracy of diagnosis and effectively identify areas of improvement.
