Choosing Wisely:

Don’t use sputum cytology to evaluate patients with peripheral lung lesions.

Rationale and Comments: Sputum cytology is not effective for evaluating peripheral lesions. For peripheral lesion evaluation, consider alternative diagnostic approaches (e.g., image guided needle aspiration).
Sponsoring Organizations:
  • American Society for Clinical Pathology
  • Sources:
  • Expert consensus
  • Disciplines:
  • Pulmonary medicine
  • Oncologic
  • References: • Demay RM, The Art & Science of Cytopathology. Chicago, IL: ASCP Press; 1996.
    • Felten MK, Knoll L, Schikowsky C, et al. Is it useful to combine sputum cytology and low-dose spiral computed tomography for early detection of lung cancer in formerly asbestos-exposed power industry workers? J Occup Med Tox. 2014; 9(14): 1-9.
    • Katz RL, Zaidi TM, Fernandez RL, et al. Automated detection of genetic abnormalities combined with cytology in sputum is a sensitive predictor of lung cancer. Mod Pathol. 2008; 21(8): 950-960.
    • Read C, Janes S, George J, Spiro S. Early lung cancer: Screening and detection. Prim Care Respir J. 2006; 15(6): 332-336.
    • Xiang D, Zhang B, Doll D, Shen K, Kloecker G, Freter C. Lung cancer screening: From imaging to biomarker. Biomarker Res. 2013; 1(4): 1-9.
    • Usman AM, Miller J, Peirson L, Fitzpatrick-Lewis D, Kenny M, Sherifali D, Raina P. Screening for lung cancer: a systematic review and meta-analysis. Prev Med [Internet] 2016 Aug. [Cited 2017 July 14]; 89:301-14.

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