81 Artifacts and histologic pitfalls in the lung thickness of a gauge steel needle is approximately 0.2 mm. The size of the displaced cells, as reported in the article by Diaz et al119, is smaller than the wall thickness of the needle. The thickness of the gross knife may vary, but ranges from 0.4 to 1 mm, which is 20 to 50 times larger than normal epithelial cells (see Figure 8), implying a tremendous force. In the context of breast fine-needle aspirate cytology, the force applied during smearing of the aspirate may cause separation of tumor cells from the main epithelial cluster. This loss of cohesion, also called ‘‘dissociation,’’ is used as a feature of malignancy. In summary, the 4 patterns of ex vivo artifacts are important to recognize so as not to compromise morphologic diagnostic accuracy. 5
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