ABSTRACT
PURPOSE: To investigate the diagnostic accuracy of a different sample preparation protocol for fine needle aspiration cytology (FNAC) of thyroid nodules established during the COVID-19 pandemic. METHODS: From April 2020, conventional smears during FNAC were ceased according to World Health Organization recommendations due to the increased infection risk for operators, and a new protocol using only liquid-based cytology (LBC) was adopted. FNACs performed between April and July 2020 (COVID-19 group) were retrospectively compared with those from December 2019 through March 2020 (Pre-COVID-19 group). The distribution of diagnoses based on SIAPEC-IAP categories and the concordance between cytological and histological results were compared using the chi-squared test. RESULTS: Categories based on FNAC for 90 and 82 thyroid nodules in the Pre-COVID-19 and COVID-19 groups showed no significant difference in distribution (P = .081), with the following respective cases (and percentages): TIR1, 7 (8%) and 8 (10%); TIR1C, 0 (0%) and 6 (7%); TIR2, 59 (66%) and 55 (67%); TIR3A, 8 (9%) and 5 (6%); TIR3B, 1 (1%) and 2 (3%); TIR4, 5 (6%) and 1 (1%); and TIR5, 10 (12%) and 5 (7%). Among patients with potentially malignant lesions, surgery was performed for 12/16 (75%) nodules in the Pre-COVID-19 and 7/8 (88%) nodules in the COVID-19 groups, with no significant differences between cytological and histological diagnoses (P = .931). CONCLUSION: The new LBC-only protocol provided similar diagnostic accuracy in comparison with conventional smears, and can be effectively applied during a viral pandemic improving operator safety.
Subject(s)
COVID-19/epidemiology , SARS-CoV-2 , Thyroid Gland/pathology , Thyroid Neoplasms/pathology , Thyroid Nodule/pathology , Adult , Aged , Aged, 80 and over , Biopsy, Fine-Needle , Female , Humans , Male , Middle AgedABSTRACT
INTRODUCTION: Air-dried slide preparation for fine needle aspiration cytology procedures is currently considered unsafe because of the risk of infectious aerosols of coronavirus 19. This study compares the safety and accuracy of two different protocols, one with and one without air-dried slides. METHODS: Starting from 3 March 2020, we discontinued the use of air-dried slides during breast fine needle aspiration procedures. We selected cases collected during two periods: 2 months before and 2 months after 3 March. In both groups, the number of procedures was recorded together with the distribution of the diagnostic categories and the concordance between cytological and histological results on surgical specimens for lesions suggestive of malignancy, using the chi-squared test. RESULTS: Of the 100 procedures performed during the pre-COVID-19 period, 55% were negative (C2), 3% were non-diagnostic (C1) and 40% were positive (C4 or C5). Of the 75 procedures obtained during the COVID-19 period, 44% were negative (C2), 2.7% were non-diagnostic (C1) and 52% were positive (C4 or C5). Despite the use of a new protocol during the COVID-19 period, we observed concordance between cytological and histological results for lesions suggestive of malignancy. There was no statistically significant difference concerning the distribution of the diagnostic categories in the two groups. CONCLUSIONS: Taking into account the slightly lower number of procedures being analysed during the COVID-19 period, the introduction of a new protocol that does not include air-dried slides is safe and reliable.
Subject(s)
Breast Neoplasms , Breast/pathology , COVID-19 , SARS-CoV-2 , Adult , Aged , Aged, 80 and over , Biopsy, Fine-Needle , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Female , Humans , Middle Aged , Retrospective StudiesABSTRACT
Italy has one of the highest COVID-19 clinical burdens in the world and Lombardy region accounts for more than half of the deaths of the country. Since COVID-19 is a novel disease, early impactful decisions are often based on experience of referral centres.We report the re-organisation which our institute (IEO, European Institute of Oncology), a cancer referral centre in Lombardy, went through to make our breast-imaging division pandemic-proof. Using personal-protective-equipment and innovative protocols, we provided essential breast-imaging procedures during COVID-19 pandemic without compromising cancer outcomes.The emergency management and infection-control-measures implemented in our division protected both the patients and the staff, making this experience useful for other radiology departments dealing with the pandemic.