Death within 30 days of fine needle aspiration

Post-mortem confirmation of FNA diagnoses and the contribution of FNA to patient mortality

David Priemer, William A. Berry, Dean A. Hawley, Harvey M. Cramer

Research output: Contribution to journalArticle

Abstract

Background: Fine needle aspiration (FNA) diagnoses are usually confirmed via surgical pathology or via evaluation of clinical outcomes. However, such confirmation may not occur for patients who die shortly after FNA, and autopsy may be a useful quality assessment tool in these cases. Also, there is little data investigating the relationship between FNA and mortality. We sought to demonstrate the autopsy as a quality assessment tool for the FNA and assess the contribution of FNA to mortality in patients who die soon after the procedure. Methods: A search of our database was performed from 1992 to 2016 for patients who were autopsied after dying within 30 d of an FNA. Concordance between findings from FNA, autopsy, and any intervening surgical pathology material was determined. Finally, a subjective determination of the likelihood that FNAs contributed to deaths was made by reviewing autopsy reports. The contribution was categorised as either “unlikely”, “possible”, or “probable”. Results: Fifty-eight patients (average age = 58 y) met the search criteria. Thirty-six (62%) patients had malignancies. Surgical pathology material was obtained concurrently or following FNA in 20 cases (34%). There was 73% concordance between FNA and autopsy findings, which compares to 80% concordance between FNA and surgical pathology diagnoses. The FNA was determined to be at least possibly contributory to death in 7/58 cases (3 cases designated as “probable,” and 4 as “possible”). Conclusion: Autopsy can be used to validate FNA diagnoses and, like surgical pathology, confirms that FNA diagnoses are mostly accurate. However, in a small number of patients, FNA can precipitate death.

Original languageEnglish (US)
Pages (from-to)993-1003
Number of pages11
JournalDiagnostic cytopathology
Volume46
Issue number12
DOIs
StatePublished - Dec 1 2018
Externally publishedYes

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Fine Needle Biopsy
Mortality
Surgical Pathology
Autopsy

Keywords

  • autopsy
  • fine needle aspiration
  • mortality
  • quality assessment

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Death within 30 days of fine needle aspiration : Post-mortem confirmation of FNA diagnoses and the contribution of FNA to patient mortality. / Priemer, David; Berry, William A.; Hawley, Dean A.; Cramer, Harvey M.

In: Diagnostic cytopathology, Vol. 46, No. 12, 01.12.2018, p. 993-1003.

Research output: Contribution to journalArticle

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