Role of Intraoperative Pathology Consultation by Imprint and Scrape Cytology in Soft Tissue Tumors and Tumor-Like Lesions

Intraoperative pathologic consultation plays an essential role in therapeutic decision making, possibly avoiding under or overtreatment of the patient. Common indications for intraoperative consultation include obtaining a diagnosis in an unknown pathology, ruling out malignancy, confirming a provisional diagnosis, and assessing margin status. Fifty patients undergoing surgery for soft tissue tumors or tumor-like lesions were included in the present prospective study to evaluate the role of intraoperative pathologic consultation by imprint and scrape cytology. Careful and quick gross examination of the specimen was performed, followed by processing for imprint and scrape smears. The prepared smears were evaluated by three pathologists and the cytological diagnosis compared subsequently with final histopathological diagnosis. Intraoperative consultation was primarily requested to make or confirm preoperative diagnosis. In 44.0% cases, no previous tissue/cytological diagnosis was available. In 56.0% cases, previous pathological diagnosis was available, but the reports were inconclusive or were reported from outside our institute. The diagnostic yield of imprint smears was 24% (5 malignant, 6 benign, and 1 inconclusive), and scrape smears was 100% (10 malignant, 38 benign, and 2 inconclusive). Paraffin-embedded sections yielded diagnosis in 100% cases (11 malignant, 38 benign, and 1 nonneoplastic). Imprint smears alone were not of much help in intraoperative diagnosis. Scrape smears were found to be superior to imprint smears in terms of diagnostic yield and accuracy. Combined imprint and scrape smear cytology did not provide any advantage in intraoperative provisional tissue diagnosis in soft tissue tumors.

CHRONIC VULVAL SYMPTOMS: COMPARISON OF VARIOUS DIAGNOSTIC METHODS

The aim of our study was to compare the various diagnostic modalities for evaluation of chronic vulval symptoms. We studied 100 women presenting with chronic vulval symptoms who underwent examination of vulva with low magnification, scrape cytology, colposcopy & directed biopsy. The overall sensitivity and specificity for detecting vulvar lesions was 29.87% and 100% with low magnification 58.44% and 13.04% with cytology 77.92 % and 17.39 % with colposcopy. We concluded that clinical examination with or without magnification can detect most of the neoplastic lesions. Colposcopy and cytology have high negative predictive value and provide reassurance in absence of disease.

ROLE OF SCRAPE CYTOLOGY IN THE DIAGNOSIS OF OVARIAN NEOPLASM AND CYTOHISTOLOGICAL CORRELATION OF OVARIAN NEOPLASM.

Aim To determine the role of scrape cytology in the diagnosis of ovarian neoplasm Material and method This was a prospective study at jlnmc duration of study was from nov 2019 to march 2020 on 100 solid/solid-cystic ovarian neoplasms sent in 10% buffered formalin, then stained with hematoxylin and eosin or Papanicolaou stains. Cytological results were compared with the histological diagnosis taking the latter as the gold standard. Result Among the 100 cases, the standard histopathological diagnosis confirmed 61 as benign, 5 as borderline and 34 as malignant lesion. The diagnostic concordance between cytological and histo pathological study was observed in 97 of the 100 cases. Characteristic cytological pattern was noted in various types of surface epithelial, sex cord stromal and germ cell tumors. The technique had limited value in mucinous tumors to distinguish borderline cases from invasive carcinoma. Conclusions IOC is a good complement to histopathology in the study of ovarian neoplasms, particularly in developing countries like ours, where the facility of frozen sections is often not available. Adequate knowledge on cyto-histological correlation of ovarian scrape cytology may phase out the use of cryostat in intraoperative diagnosis of ovarian neoplasms.

Utility of scrape cytology in the diagnosis of ovarian masses

Background: Cytology is a useful adjunct to frozen section for rapid diagnosis of neoplastic pathology. However frozen section facility is available in limited centres. Therefore, we undertook this study to find out role of scrape cytology for diagnosis of ovarian masses.Methods: It is an observational study done in a medical college. One hundred ovarian masses were collected for a period of eighteen months. Cut surface of ovarian masses were scraped with edge of a glass slide. Smears were prepared and stained with H and E stain, examined and a presumptive diagnosis was given. The verification of cytological diagnosis was done by histopathological report. All the data were recorded, tabulated and analyzed with the help of standard statistical methods using Microsoft XL.Results: A total of hundred cases were studied. Left ovary was involved in 38 cases, right ovary in 52 cases and bilateral ovaries in 10 cases. Malignant cases mostly yielded hyper cellular smear. On Chi square test, it was significant with value of less than .001. The overall sensitivity and specificity of scrape cytology in diagnosing ovarian neoplasm, considering HPE as gold standard, are 98% and 78% respectively. In Dysgerminoma, Papillary adenocarcinoma, Mucinous Cystadenoma, Benign cystic teratoma, Granulomatous lesion of ovary, Lymphoma and Mucinous adenocarcinoma, scrape diagnosis corroborated with the histological diagnosis. Notable discrepancy was seen in cases of Endometrioid carcinoma.Conclusions: Scrape cytology can serve as a powerful tool for early diagnosis of ovarian masses in close cooperation of the clinician, radiologist and pathologist. It has a potential for widespread use as knowledge and experience of interpreting cytopathologists increase.

Role of Intraoperative Scrape Cytology in Diagnosis of Palpable Breast Lump

Background: Diseases of the breast constitute a significant proportion of surgical cases and frequently, the need arises to distinguish benign from malignant lesions prior to definitive treatment. So far, Frozen Section (FS) is the standard technique with high level of validity. However, intraoperative scrape cytology can be adopted when special facilities of FS are not available. Methods: This study designed with the aim to evaluate the value of Intraoperative Scrape Cytology (IOSC) in providing rapid and accurate diagnosis for breast lump and to compare its diagnostic yield with that of paraffin sections. This cross sectional descriptive study was carried out in the Department of Pathology, Chittagong Medical College in collaboration with Department of Surgery of this institution from October 2013 to September 2014. The study conducted on 123 patients with breast lumps who underwent operative treatment. Scrapings were taken from each specimen before formalin fixation and stained by rapid Papanicolaou staining. In each case their accuracy was compared to histopathological diagnosis. Statistical analysis done employing c2 test. Results: Out of 123 cases studied, 122 could be correctly differentiated into benign and malignant tumors with an accuracy rate of 99.19%. Conclusion: Intraoperative Scrape Cytology (IOSC) is a simple, accurate, rapid and cost-effective diagnostic tool, not requiring specific instruments in contrast to frozen section, can be used peroperatively for both diagnosis and management of breast lump. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 26-30