Current Practices in Laboratories With Respiratory Nongynecologic Cytology Specimens: A Survey by the College of American Pathologists Cytopathology Committee.

Abstract

In 2013, the Cytopathology Committee of the College of American Pathologists conducted its first survey on the practice patterns of laboratories performing respiratory cytology. To capture current laboratory practices, recognize changes in respiratory cytopathology practices over the last decade, and provide insight into future directions for improvement. The survey was mailed to 1979 laboratories. The survey results show a high demand for respiratory cytology. There has been a shift regarding the preferred technique to endobronchial ultrasound-guided fine-needle aspirations as one of the most frequently processed and interpreted specimens, and the most commonly performed intraprocedural assessments. The pathologist alone mostly performed intraprocedural assessments, followed by the cytotechnologist alone. The immunostaining markers used to differentiate non-small carcinomas were most commonly the panel p63, CK5/6, and p40 for squamous cell carcinoma or TTF-1 and Napsin A for adenocarcinoma, compared with a single stain for either. Molecular testing for non-small cell lung carcinomas was commonly performed, with most molecular testing being sent to an outside laboratory. Immunohistochemical stains were validated in half of the institutions, with a high number responding that they were unsure of the validation performed in their laboratories. This follow-up study of our original study has shown significant advances in the field of respiratory cytology. The data also showed a few areas, specifically validation of cytology preparations for ancillary testing and molecular testing, which may benefit from guidelines to standardize cytopathology practice and ensure quality care.