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OPA /UCSF
FNA BIOPSY CONSULTATION
JOHN S. ABELE, MDOUTPATIENT PATHOLOGY ASSOCIATES
3301 C Street; Suite 103CSacramento, CA 95816
916-444-0889 voice916-444-6016 faxabele@outpatientpathology.com
OPA /UCSF
Smearing Techniques
• Purpose– Monolayer Dispersion– Mild Cohesion Test
Character Techique• Semisolid → One Step• Fluid → Two Step• Fluid in Hub → Snap• Fluid with Particles → Crackle• Fluid in Syringe → Pop
Diagn Cytopathol. 1985 Jan-Mar;1(1):59-65.
OPA /UCSF
Original One & Two Step Technique – Zajicek 1974
One Step(Semisolid)
Two Step(Fluid)
OPA /UCSF
One Step Technique
OPA /UCSF
One Step Technique – Right Handed
Diagn Cytopathol. 1985 Jan-Mar;1(1):59-65.
Contact Line
Rotation TargetLine
OPA /UCSF
Original One Step Technique
John S. Abele,MD Page 1 of 4
Smearing Techniques
OPA /UCSF
FNA SMEAR ARTIFACTS
SKIP AND POP-OFF
OPA /UCSF
Two Step Technique
OPA /UCSF
Two Step Technique
OPA /UCSF
Two Step Technique
OPA /UCSF
Two Step Technique
Fluid
Particles
OPA /UCSF
Two Step Technique
2ed FluidConcentration
Particles
John S. Abele,MD Page 2 of 4
Smearing Techniques
OPA /UCSF
Two Step Technique
OPA /UCSF
Two Step Technique
OPA /UCSF
Two Step Technique
OPA /UCSF
Two Step Technique
OPA /UCSF
Contact Line
Target TissueTarget TissueTarget Tissue
Top EdgeRotates Down
Modified One Step End
OPA /UCSF
Two Step Technique
John S. Abele,MD Page 3 of 4
Smearing Techniques
OPA /UCSF
FNA SMEAR ARTIFACTS
WICK CONCENTRATION
OPA /UCSF
INCLINE CONCENTRATION
OPA /UCSF
THE SNAP TECHNIQUE
OPA /UCSF
POP TECHNIQUE
OPA /UCSF
POP TECHNIQUE
OPA /UCSF
FNA BIOPSY OF BREAST
INFLUENCE OF # OF BIOPSIES
4 BIOPSIES OF 400 LESIONSINCREMENTAL CONTRIBUTION
1ST BIOPSY ~70% DIAGNOSTIC2-4 DECLINING YIELD (20, 6, 4)
TARGET TYPESBENIGN / MALIGNANT: SAME OUTCOMESMALLER TARGETS: BETTER INCREMENTAL YIELD
SENSITIVITY vs. #BX - RMS CURVE FIT~100% SENSITIVE AT 9-10 BXS4 "OPTIMAL YIELD"
PENNES. ACTA CYTOL 34:673,1990
John S. Abele,MD Page 4 of 4
Smearing Techniques
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