[Histonet] Re: FNA

[Bob Richmond]

Needle biopsies, whether tissue core or FNA, require a great deal of
co-operation and interplay among pathologist, cytotechnologist, and
radiologist. Just how this works depends on the skills of the people
involved.

For example, one place I work has a senior pathologist who is highly
skilled at performing and interpreting FNA's. We have no in-house
cytotechnologist there, and the radiologists are from a large group
that rotates through on a one-day basis from a distant site, so we
never know what radiologist we'll have.

At another place, the pathologist is rarely available, but the
cytotechnologist is highly skilled at assisting a radiologist or other
clinicians. The in-house radiologist is also highly skilled, but we
have to work with a minimum of clinical information.

In all of this, the needs of the individual patient need to be
considered. A frequent issue: does part of the specimen need to be
sent out for flow cytometry? Is unfixed tissue needed for some special
cancer study? And there's the uh-oh moment when you aspirate pus and
find out that what's needed is cultures.

This is one of those situations where things aren't going to get
better until the bean counters figure out that our lack of access to
information is costing big bucks. At age 73, I don't expect to see it.

Bob Richmond
Samurai Pathologist
Knoxville TN