Clinical utility of rapid on-site cytopathology

Published:August 23, 2016DOI:
      EUS-guided FNA (EUS-FNA) is an important technique for evaluating pancreatic lesions, lymphadenopathy adjacent to the intestinal tract, and GI subepithelial lesions. Rapid on-site evaluation (ROSE) involves the immediate application of the EUS-FNA sample from the EUS needle to a slide that is quickly stained and examined, typically in the endoscopy suite. The samples may be evaluated by a cytotechnician, a cytopathologist, or both. The simplicity and utility of the ROSE technique are not typically appreciated by those not performing EUS. We present 4 case scenarios that demonstrate ROSE slide preparation and examination (Video 1, available online at; Fig. 1). The ROSE technique may improve diagnostic yield and allow for adjustments in EUS-FNA technique. In addition, if an immediate diagnosis of malignancy is made, patient care may be expedited.
      Figure thumbnail gr1
      Figure 1Diff-Kwik staining of a slide for rapid on-site evaluation (ROSE).
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