Diagnostic utility of imprint cytology of ovarian neoplasm: A cyto-histological comparison

Abstract

Background: Intra-operative cytology (IOC) is a method of intra-operative pathological evaluation of cytology smears. The most important indication for IOC is to establish or confirm diagnosis rapidly. Other advantages of IOC are its simple, inexpensive, excellent preservation of cellular details, with no loss of tissues as occurs with cryostat sections and adequacy of surgical margins. Frozen sections are well established method for providing rapid and accurate intra-operative diagnosis. Objective: To evaluate the diagnostic utility of imprint cytology and assess the accuracy of imprint cytology with histopathological diagnosis obtained from ovarian neoplasm. Materials and Methods: Imprint smears were prepared immediately from all the ovariotomy specimens. The specimens were sent for histopathology along with prepared smears to categorize as benign, borderline and malignant. Sensitivity, specificity and accuracy were assessed. Results : Among the 99 specimens studied, 80 were benign, 9 borderline and 10 malignancy according to histopathology. We found that sensitivity, specificity, for benign lesions were 100%, 42.1% and for malignant lesions were 80%, 91.9% respectively. The overall accuracy was 89%. Conclusion : Imprint smear of ovarian neoplasm gives a rapid diagnosis with 89% accuracy against histopathology with added advantages. Imprint cytology is an adjunct to frozen section for providing an intra-operative diagnosis; however, in resource poor settings, it can be used as a stand-alone method for aiding intra-operative decision making. Keywords: Imprint smear, Histopathology, Ovarian neoplasm, Intraoperative cytology.