The Significance of Atypia in Fine Needle Aspiration Cytology of the Prostate

Abstract

Of 411 fine needle aspirates of the prostate 208 could be matched with conventional pathological material. Cytological diagnosis had a complete sensitivity of 94 percent, specificity 99 percent and efficiency 74 percent. Corresponding figures for 36 patients who underwent total prostatectomy were complete sensitivity 100 percent, specificity 100 percent and efficiency 78 percent. Atypical cytology results not amounting to frank malignancy were the main reasons for reduced efficiency and, therefore, analysis of the significance of atypia was performed. In 50 aspirates from 43 patients atypia of varying degree were noted but the degree of atypia did not allow for a diagnosis of malignancy. Subsequent diagnosis of carcinoma was made by cutting needle biopsy or transureteral resection in 7 of 14 specimens (50 percent) of severe, 3 of 9 (33 percent) moderate, 3 of 7 (43 percent) mild and 3 of 16 (19 percent) reactive atypia. Thus, specific cytological diagnoses have a high degree of accuracy but atypia and attempts to categorize it did not predict accurately the final diagnosis. Pathological conditions that may account for atypia in fine needle aspiration cytology are reviewed.