Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies

With the advances in minimally invasive sampling techniques, laboratories can perform multiple ancillary studies on small biopsy and cytology specimens to help in the diagnosis and management of pulmonary pathology. To provide treating physicians with valuable diagnostic, predictive, and prognostic information from small biopsy and cytology specimens, it is critical to establish evidence-based recommendations for the appropriate collection, handling, and triage for relevant ancillary tests.

The “Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies” guideline divides the recommendations into six main categories: Endobronchial Ultrasound Guided Transbronchial Procedures, Transthoracic Procedures, Bronchoscopic Procedures, Pleural Effusions, Considerations for Ancillary Studies During Malignant Investigations, and Considerations for Ancillary Studies During Non-malignant Investigations. It also addresses common variables that impact specimen adequacy and diagnostic yield such as:

• needle gauge
• number of passes
• how the content of the needle is expelled
• use of fixatives
• when to employ rapid on-site evaluation

Guideline Status: Active
Published online ahead of print: May 13, 2020
Originally published: August 2020

The following tools and resources are available to help implement the guideline:

• Summary of Recommendations
• Methodology Supplement (Supplemental Digital Content)
• Teaching Presentation
• Frequently Asked Questions
• Infographic

• CHEST
• ACS
• ATS
• AMP
• PSC
• PPS
• SIR
• STR

Review more upcoming CAP evidence-based guidelines by the Pathology and Laboratory Quality Center.