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Global Cytopathology-Hematopathology Practice Trends
Sara L Zadeh1, Ronald Balassanian2, Matthew C Cheung3
1Department of Pathology, Stanford University, Stanford, CA, USA.
Insights
Small-volume biopsies for lymphoma diagnosis are common, but communication between hematopathology and cytopathology services is inconsistent. This lack of uniformity impacts diagnostic accuracy and patient management.
Area of Science:
- Pathology
- Hematology
- Oncology
Background:
- Small-volume biopsies, including fine-needle aspiration biopsy (FNAB) with or without core biopsy, are increasingly utilized for lymphoma diagnosis and management.
- Effective integration of FNAB, core biopsy, and flow cytometry is crucial for accurate lymphoma diagnosis.
Purpose of the Study:
- To survey current practices in small-volume biopsy diagnosis of lymphoma.
- To assess the interaction between hematopathologists and cytopathologists.
- To evaluate the integration of FNAB, core biopsy, and flow cytometry data during the sign-out process.
Main Methods:
- A cross-sectional survey design was employed using the RedCap database.
- The survey was distributed via email listservs of nine pathology professional societies.
- 128 pathologists participated, answering 25 multiple-choice questions and free-text fields.
Main Results:
- A majority of respondents (58.6%) encounter FNAB specimens for lymphoma diagnosis (FNAB-L) daily or weekly.
- Most institutions (62.1%) have separate hematopathology and cytopathology services with inconsistent communication.
- Identified barriers included poor communication, limited access to diagnostic studies, lack of subspecialty training, and differing opinions on FNAB for lymphoma diagnosis.
Conclusions:
- FNAB-L specimens are frequently encountered in clinical practice.
- There is a notable lack of uniformity in sharing complementary biopsy and flow cytometry data between hematopathology and cytopathology services.
- Improved communication and standardized protocols are needed for optimal lymphoma diagnosis using small-volume biopsies.
Objectives:
Small-volume biopsy-fine-needle aspiration biopsy (FNAB) with or without core biopsy-is in increasing use in diagnosis and management of lymphoma patients. Our objective was to survey the current practice in small-volume biopsy diagnosis of lymphoma, focusing on the interaction among hematopathologists and cytopathologists and the integration of FNAB, core biopsy, and flow cytometry studies at sign-out.
Methods:
This study used a cross-sectional survey design employing the RedCap database distributed via nine pathology professional society email listservs. The survey consisted of 25 multiple-choice questions and several free text fields. In total, 128 pathologists participated.
Results:
Most respondents indicated that FNAB specimens in which lymphoma is a diagnostic consideration (FNAB-L) are seen daily or weekly (68/116; 58.6%). However, most institutions have separate hematopathology and cytopathology services (72/116; 62.1%) with inconsistent communication. When communication occurred, respondents were frequently inclined to reconsider their original diagnoses. Barriers identified included lack of communication, inadequate access to diagnostic studies, no formal subspecialty training, and various opinions regarding FNAB in diagnosing lymphoma.
Conclusions:
This survey showed that FNAB-L specimens are common, with a lack of uniformity in how complementary fine-needle aspiration and core biopsy specimens or flow immunophenotyping results are shared across hematopathology and cytopathology services.
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