Cytopathology in Focus: Adequacy in cytopathology: an overview with a focus on FNA of lymph nodes and mass lesions

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In each case that is not adequate, communication is key to ensure the patient workup continues and they aren’t lost to follow-up. Consequently, it is recommended that an explanatory comment be included stating the reason for the non-diagnostic/inadequate specimen, such as: “The findings in this case do not appear to explain or be representative of the reported mass lesion. As a result, the case is best categorized as non-diagnostic and repeat sampling should be considered.”

In summary, the criteria for adequacy in many cytopathology specimen types is still evolving. However, the underlying theme continues to be focused on the question: Is the material sufficient to help answer the clinical question? In cytopathology, this question will continue to be related to specimen quantity and quality, as well as correlation with the clinical scenario.

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Dr. Manucha is clinical professor, Department of Pathology, University of Mississippi Medical Center. Dr. Ribeiro is resident physician, Department of Pathology, Johns Hopkins University School of Medicine. Dr. Magers is staff pathologist, Trinity Health IHA Pathology and Laboratory Management, Ypsilante, Mich. Dr. Allison is assistant professor, Department of Pathology and Laboratory Medicine, University of Kentucky College of Medicine. Drs. Manucha, Magers, and Allison are members of the CAP Cytopathology Committee. Dr. Ribeiro was a member through 2022 and at the time of this writing.