CASE STUDIES IN CYTOLOGY

DR NOORASMALIZA MD PAIMAN
HOSPITAL SULTANAH BAHIYAH ALOR SETAR, KEDAH
HISTO-CYTO CORRELATION

Case 1

• 35 yr old lady, routine pap smear

• Overcalled LSIL for normal pap smear by MLT and junior pathologist
Case 2

• 40 yr old lady, routine pap smear. Normal cervix finding.

• Pap smear shows low cellularity of smear with a few hyperchromatic
crowded group of cells. Reported as ASC-H.
Case 3
• 36 yr old lady, blood stained left nipple discharge.
• Unable to appreciate definite breast lump.
• Nongynae sample: Nipple discharge.
• USG-guided biopsy done later due to suspicious BIRADS 4 non palpable
lesion observed.
• Trace retrospectively cytology cases that have histological
findings.
• Check for discordant cases.
• Retrieve the slides.
• Histo-cyto correlation discussion.
• True discordant cases are selected and recorded. Teaching session
is concurrently done.
EQA - RCPA
• 4 cycle per year
• Each cycle: 5 slides conventional Gynae cases, 5 slides thinprep Gynae cases, 2
FNA cases, 2 Non gynae cases (total: 14 slides per cycle, 56 slides per year)
• Upon receive, each MLT and pathologist need to review the cases and give
answers individually, then, we discuss the answers and get the consensus
• Submit result online
• RCPA email preliminary result followed by full report with the diagnostic code
• Second discussion for any discordant result
• Person in charge will do the marking for overall (unit) and invidually
CASE 4
NON CONFORMITIES

• For any error occurs in the lab up to wrong diagnosis received by the client,
need to be recorded (nonconformance form)
• Identify the root cause, SIQ factor, risk category
• Small meeting at unit level to get the solution (corrective and preventive action)
• Give date to review again
• Also discuss during 3 monthly NC meeting at Depeartment level
CASE 5