THIS ‘ROSE’ HAS NO THORNS - DIAGNOSTIC UTILITY OF ‘RAPID ON-SITE EVALUATION’ (ROSE) IN FINE NEEDLE ASPIRATION CYTOLOGY
Background: Fine-needle aspiration cytology (FNAC) is a basic diagnostic technique used to investigate superficial and deep swellings. ROSE using toluidine blue is easily available, cheap, cost effective and can be used for quick reporting.
Aims & objectives: To evaluate the role of ROSE using toluidine blue staining. Correlation of ROSE findings with Geimsa/PAP findings.
Material & methods:
A prospective study in which 1500 cases from Sept 2016 - May 2017 were stained on site with Toluidine blue (TB) followed by routine staining.
Results: Non guided FNA was done from various sites like salivary gland, breast, thyroid, lymph node, soft tissues etc. Overall, only 32(2%) cases were inadequate on TB, Geimsa & PAP combination, most common site of inadequacy being lymph node. Adequate sample was obtained in 1st and 2nd pass in 92.5% cases. Cell block was collected in 39 cases, of which NHL (25.6%) and high grade carcinoma (20.5%) were the commonest. Turn-around time was one day in 96.4 % cases. The average time taken for making a provisional diagnosis on TB was 3 minutes. There was 99.2% concordance between TB and final cytodiagnosis. Validity parameters were sensitivity (98%); specificity (100%); positive predictive value (100); negative predictive value (99.8%); efficacy (99.2%); false positive (0%); false negative (1.94%).
Conclusion: This is a reliable way of demonstrating adequacy. It can be useful to give a provisional diagnosis and guide further processing like collection of material for ICC, cell block, Gene expert/MGIT etc. The technique is easy enough for general laboratories to incorporate into their routine.
At the recent International CME in Pathology organized in Goa from 2nd February 2018 – 4th February 2018, Dr. Santosh Tummidi was awarded the second prize for a brilliant oral paper presentation.