Elsevier

Human Pathology

Volume 20, Issue 6, June 1989, Pages 504-517
Human Pathology

Symposium
Needle aspiration biopsy: Past, present, and future

https://doi.org/10.1016/0046-8177(89)90242-6Get rights and content

Abstract

Since its inception more than 50 years ago at Memorial Hospital for Cancer (New York), needle aspiration biopsy has traveled to its present popularity over a torturous road. The early influence of Stewart on the interpretation of aspiration smears and the use of this biopsy method is still worthy of review, particularly the importance of close cooperation between clinician and pathologist. While cytology has been profoundly influenced by individual cell interpretation as practiced by Papanicolaou, it is really pattern recognition that dominates successful diagnosis by the aspiration biopsy smear method. Present concerns over technical variation in procurement of the biopsy and staining methods should be of less importance than identification of the aspiration methodology that produces the best-quality microscopic image. Reliability of diagnosis by aspiration smear must also be judged by a suitable and reproducible standard, something that is not necessarily fulfilled by tissue pathology, although many would believe otherwise. The author proposes that aspiration may also now be judged, like tissue pathology, by clinical outcome. The application and ease of procuring cell samples from tumors for cell image analysis, for flow cytometry and ploidy studies, and for gene rearrangement place this biopsy method in the forefront of the integration of biologic research and clinical medicine. Aspiration biopsy has caused us to explore how the human eye and brain analyze microscopic images and may even assist in the design of useful artificial intelligence diagnostic systems in the future.

References (52)

  • H.E. Martin et al.

    Biopsy by needle puncture and aspiration

    Ann Surg

    (1930)
  • F Stewart

    The diagnosis of tumors by aspiration

    Am J Pathol

    (1933)
  • L.G. Koss et al.

    Aspiration Biopsy. Cytologic Interpretation and Histologic Bases

    (1984)
  • W.J. Frable

    Thin-Needle Aspiration Biopsy

  • M Kun

    A new instrument for the diagnosis of tumours

    Monthly J Med Sci

    (1947)
  • A.J. Webb

    Through a glass darkly. (The development of needle aspiration biopsy)

    Bristol Med Chir J

    (1974)
  • J.A. Linsk

    Aspiration cytology in Sweden: The Karolinska group

    Diagn Cytopathol

    (1985)
  • P Lopes-Cardozo

    Clinical Cytology

    (1954)
  • N Soderstrom

    Fine Needle Aspiration Biopsy

    (1966)
  • E.P. Mannheim

    Die Bedeutung der Tumorpunktion für Tumordiagnose

    Z Krebsforsch

    (1931)
  • J.A. Linsk et al.

    Clinical Aspiration Cytology

    (1983)
  • I Koprowska

    Aspiration biopsy

  • S Orell et al.

    Manual and Atlas of Fine Needle Aspiration Cytology

    (1986)
  • M.D. Glant

    Fine needle aspiration biopsy. Techniques

  • S Franzen et al.

    Cytologic diagnosis of prostatic tumors by transrectal aspiration biopsy. A preliminary report

    Br J Urol

    (1960)
  • H.D. Thomson

    Thin needle aspiration biopsy

    Acta Cytol

    (1982)
  • W.J. Frable et al.

    Fine needle aspiration biopsy. Applications in the diagnosis of lymphoproliferative disease

    Am J Surg Pathol

    (1988)
  • L Walaas et al.

    A correlative cytologic and histologic study of malignant fibrous histiocytoma: An analysis of 40 cases examined by fine-needle aspiration cytology

    Diagn Cytopathol

    (1986)
  • J.P.A. Baak et al.

    A Manual of Morphometry in Diagnostic Pathology

    (1983)
  • D.W. Penner

    Quality control and quality evaluation in histopathology and cytology

  • C Rogers et al.

    Accuracy of frozen-section diagnosis in a teaching hospital

    Arch Pathol Lab Med

    (1987)
  • Z Kaufman et al.

    Frozen-section diagnosis in surgical pathology. A prospective analysis of 526 frozen sections

    Cancer

    (1986)
  • J Zajicek et al.

    Aspiration biopsy of mammary tumors in diagnosis and research. A critical review of 2200 cases

    Acta Cytol

    (1967)
  • M Cornillot et al.

    Place de la cytologie par fonction dans la diagnostic des tumeurs du sein (2267 examens cytologiques)

    Liile Med

    (1971)
  • G Starvic et al.

    Aspiration biopsy cytologic method in diagnosis of breast lesions—A critical review of 250 cases

    Acta Cytol

    (1973)
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