Diagnostic utility of imprint cytology in assessing surgical margins during laparoscopic partial nephrectomy.

Among various specimen preparation techniques for rapid on-site evaluation (ROSE), touch imprint cytology (TIC) is widely used; however, its utility for pancreatic lesions has not been fully validated. This study aimed to evaluate the diagnostic performance of TIC-based ROSE during endoscopic ultrasound-guided tissue acquisition (EUS-TA) for pancreatic lesions. This retrospective study included 385 patients who underwent EUS-TA for pancreatic lesions at a single center. ROSE using TIC was performed in 370 cases (96.1%). Diagnostic concordance between TIC-based ROSE and histology, as well as diagnostic accuracy relative to the final diagnosis, were assessed. The diagnostic performance of TIC was compared with that of spray cytology (SC) and instrument rinse cytology (IRC). Multivariate analysis was conducted to identify factors associated with discordance between TIC-based ROSE and histology. The concordance rate between TIC-based ROSE and histology was 85.1% (κ=0.575). For the final diagnosis, TIC-based ROSE demonstrated a sensitivity of 92.3%, specificity of 96.9%, and accuracy of 92.7%, showing superior diagnostic performance within the same workflow compared with SC and IRC. Smaller lesion size and the use of a 25-gauge needle were identified as independent factors for discordance. TIC is a reliable ROSE technique in EUS-TA for pancreatic lesions, providing high diagnostic accuracy and a low inadequacy rate.

BackgroundUltrathin cryobiopsy (CB) using a 1.1-mm cryoprobe has been shown to improve the diagnostic yield of bronchoscopy for peripheral pulmonary lesions (PPLs). However, CB may not be actively adopted in some institutions because of concerns about bleeding and pneumothorax. Each facility needs to develop its own strategies to perform CB selectively and safely. Rapid on-site cytologic evaluation of touch imprint cytology (ROSE-TIC) of small (1.5 mm) forceps biopsy (FB) may help guide the selective application of CB. This study aimed to evaluate the safety and efficacy of adding CB in patients with ROSE-TIC-negative FB.MethodsPatients with PPLs <30 mm were enrolled in this single-center prospective study. First, they underwent bronchoscopic biopsy with a 1.5-mm FB and ROSE-TIC. CB using a 1.1-mm cryoprobe was added only when the ROSE-TIC of the FB was negative. Safety outcomes (especially bleeding) and diagnostic yields were compared solely between ROSE-TIC-positive and ROSE-TIC-negative groups. In addition, the diagnostic yield of FB results, regardless of ROSE-TIC positivity or negativity, was evaluated. The specimen sizes and ROSE-TIC accuracies were also assessed.ResultsFrom November 2023 to March 2025, 50 patients underwent bronchoscopic examinations according to the intended protocol. Grade ≥3 bleeding events did not occur, and Grade 1–2 bleeding was not significantly different between the ROSE-TIC-positive and ROSE-TIC-negative groups (P=0.35). The specific diagnostic yield of the ROSE-TIC-positive group was 87.5%, and that of the ROSE-TIC-negative group was 73.l%. In the ROSE-TIC-negative group, the FB-only results made a specific diagnosis in 34.6% [95% confidence interval (CI): 17.2–55.7%] compared with combined CB in 73.1% (95% CI: 44.3–82.8%). The overall diagnostic yield of specific findings was significantly higher in the combined CB group than that in the FB group (80% vs. 60%; P≤0.01). Additional CB provided diagnostic benefits, particularly for small lesions of ≤20 mm (73.6% vs. 52.6%, P=0.01), and partial solid nodules on computed tomography were more beneficial for pathological findings with additional CB (76% vs. 41%, P=0.04). CB samples were significantly larger than FB samples (median 2.70 vs. 1.35 mm2; P<0.001). ROSE-TIC demonstrated a sensitivity of 79.3% and specificity of 95.2%.ConclusionsThe selective addition of a 1.1-mm CB based on ROSE-TIC results of FB is a safe, feasible, and effective strategy for improving the specific diagnostic yield. This approach may be particularly beneficial for small PPLs of ≤20 mm.

BackgroundThis study aimed to investigate the impact of molecular subtype on the accuracy of intraoperative touch imprint cytology (ITPC) for sentinel lymph node (SLN) evaluation in clinically axillary node-positive (cN +) breast cancer patients treated with neoadjuvant chemotherapy (NAC).MethodsWe conducted a retrospective cohort study of 232 cN + breast cancer patients undergoing NAC followed by SLN biopsy with ITPC. Diagnostic performance values (sensitivity, specificity, NPV, false-negative rate, etc.) were calculated against final histopathological diagnosis, and stratified by molecular subtypes.ResultsITPC identified 53 positive cases (23 false-negatives) across 917 SLNs, demonstrating 69.74% sensitivity, 100% specificity, and 87.15% NPV. HER2-positive (nonluminal) tumors showed the highest tpCR (67.53%) with a moderate SLN-positive rate (24.14%) and the lowest false-negative rate (3.90%). Luminal B (HER2-positive) tumors exhibited a moderate tpCR (57.89%) and a SLN-positive rate (29.31%) but a higher false-negative rate (13.79%). In contrast, both Luminal A and Luminal B HER2-negative displayed lower tpCRs (0.00% and 20.00%), higher SLN-positive rates (66.67% and 57.78%), and higher false-negative rates (33.33% and 22.22%). Notably, TNBC showed a tpCR of 48.98%, a SLN-positive rate of 34.69%, and the lowest false-negative rate of 2.04%. Chemotherapy-induced changes in SLNs (OR = 11.155, 95% CI 2.002–62.152; p = 0.006) and residual micrometastases/ITCs (OR = 37.843, 95% CI 5.031–284.671; p < 0.0001) were independent influencing factors of false-negative results.ConclusionsCollectively, our study demonstrates that ITPC exhibits a robust accuracy for detecting SLN metastases in cN + breast cancer patients treated with NAC. The findings support the implementation of molecular subtype-specific SLN management: ITPC alone may be adequate for HER2-positive and TNBC tumors; for hormone receptor-positive (Luminal) subtypes, ITPC may need to be combined with molecular/immunohistochemical analysis.

Intraoperative cytological consultation (IOC) is a practical, rapid, and reliable method for evaluating central nervous system (CNS) tumors, enhancing the neurosurgical oncological approach. While some studies have used Papanicolaou (Pap) staining for diagnosis, its exact contribution in comparison to the rapid hematoxylin and eosin (HE) staining technique and its cytological staining characteristics remains to be fully clarified. During 12 months, this prospective study examined and contrasted the final histopathological section diagnoses of 161 specimens collected from 146 consecutive patients who received intraoperative touch-imprint cytology (TIC) and squash smear preparation (SP) techniques, using both HE and Pap staining methods. The diagnostic accuracy of TIC, relative to the final integrated histopathological diagnosis, was 85.1%. Although data for frozen sections were not separately quantified, TIC remains a rapid, reliable, and practical method for intraoperative evaluation. The evaluation of CNS lesions is best achieved by histopathology, which is considered the gold standard. The most common neoplasms were glioblastoma IDH-wild type, metastatic cancers, pituitary neuroendocrine tumor (adenoma), and meningiomas. Kappa statistics between Pap and HE staining demonstrated very good overall agreement (kappa 0.9-1, p < 0.01) across all assessed cytological features, with the highest concordance observed for nuclear details, artifacts, mitotic background, necrosis, and cytoplasmic details. Although the Wilcoxon rank-sum test indicated small but statistically significant differences in the median scores for nuclear details and artifacts, these differences reflect minor quantitative variations and do not affect the very good overall agreement between the two staining methods. Intracranial TIC and SP specimens stained with both HE and Pap demonstrated excellent diagnostic performance, characterized by high sensitivity and specificity. The combined use of Pap staining alongside HE provides a reliable and effective alternative to traditional cytological staining methods.

The indication for sublobar resection is determined based on radiologic findings, but some cases exhibit radiology-pathology discordance. This study aimed to examine the impact of histologic subtypes on radiology-pathology discordance and their preoperative predictability. We reviewed 585 patients with clinical stage IA adenocarcinoma and examined the relationship between radiology-pathology discordance and histologic characteristics, focusing on high-grade components: solid (SOL) or micropapillary (MIP). The predictive ability of radiologic or cytopathologic examinations for those subtypes was evaluated. Radiology-pathology discordance was found in 148 (25.2%) patients and was significantly associated with the presence of histologic high-grade components, with 71.9% and 70.4% of patients with upstaged lymph node and pleural invasion statuses having high-grade components. The preoperative prediction of high-grade components varied between subtypes, and radiographically pure-solid appearance and high maximum standardized uptake value were independent predictors of the SOL subtype, but not MIP. Among pre- or intraoperative cytopathologic examinations, intraoperative touch imprint cytology exhibited superior detection ability for MIP component. Histologic high-grade components are highly associated with radiology-pathology discordance in early-stage lung adenocarcinoma. Radiologic assessment would be beneficial for predicting the SOL subtype, but not MIP. Alternatively, intraoperative cytologic assessment would complement the detection of MIP subtype.

Intra-operative staging of canine mast cell tumour (MCT) currently relies on routine cytology to determine nodal metastasis. While frozen section nodal histopathology is commonly used in humans, its applicability to veterinary settings is poorly characterised. The goal of this study was to determine the diagnostic performance of frozen section (FS) histopathology for diagnosing metastatic MCT, as compared to a formalin-fixed histopathologic gold standard. Performances of imprint cytology (IC) and fine needle aspirates (FNA) were also evaluated. Forty-one lymph nodes from 20 dogs with MCT were collected and stained with haematoxylin and eosin (HE) and Giemsa (formalin-fixed and frozen tissues), and Wright Giemsa and toluidine blue (IC and FNA). Nineteen out of 20 primary tumours were low grade. Frozen HE sections had poor agreement as compared to formalin-fixed HE histopathology (κ = 0.15); however, diagnostic performance increased to a good level of agreement when interpretation was combined with Giemsa (κ = 0.46). FNA and IC using Wright Giemsa had agreement comparable to combined frozen section histopathology (κ = 0.51 and 0.43, respectively). Combined frozen sections had a sensitivity of 65% and specificity of 93%, which was the same as FNA. Challenges encountered in morphologic interpretation of frozen sections included inadequate sectioning quality, architectural disruption, ruptured cells, and background metachromatic staining. These data provide support for FS histopathology as a feasible strategy for intra-operative detection of metastatic MCT, with diagnostic agreement similar to conventional cytology. Performance of FS histopathology is conditional upon a metachromatic stain evaluated in parallel with HE.

Delays in breast cancer diagnosis remain a critical barrier to timely care in low-resource settings. In this study, we evaluated the diagnostic accuracy, feasibility, and clinical impact of Touch Imprint Cytology (TIC) of core needle biopsies. TIC demonstrated high sensitivity and specificity for detecting malignancy, allowing same-day breast cancer diagnosis and earlier initiation of treatment decisions without the need for repeat visits. This easy-to-perform, frugal, innovative, pragmatic solution requires minimal resources, and can easily be integrated into existing diagnostic workflows in low-resource environments.

Sentinel lymph node biopsy (SLNB) is a key procedure for evaluating axillary lymph node status in early breast cancer, offering lower morbidity than axillary lymph node dissection. Intraoperative evaluation (IOE) of sentinel lymph nodes (SLNs) with methods like frozen section (FS) and imprint cytology (IC) aid in making immediate surgical decisions, although IOE accuracy may vary due to several factors. This retrospective study involved 2,528 patients with invasive breast cancer who underwent SLNB at a single institution from 2012 to 2024. Primarily, IC was used for intraoperative assessment, while FS was selectively performed in certain cases, such as with suspicious macroscopic findings or after neoadjuvant chemotherapy (NAC). The final diagnosis relied on permanent sections with serial step-leveling and classification of metastasis size. IOE showed a sensitivity of 65.8% and specificity of 97% for detecting lymph node metastases. The combination of IC and FS yielded higher sensitivity (76.1%) compared to IC alone (64.1%), particularly for isolated tumor cells (ITC). Patients treated with NAC exhibited slightly lower IOE accuracy (83.8%) compared to those without NAC (85.9%). False negatives were more common in cases of micrometastasis, ITC, and invasive lobular subtype. Excluding micrometastasis and ITC significantly enhanced IOE accuracy. The accuracy of intraoperative SLN evaluation is affected by size of the metastasis, tumor subtype, and prior NAC. While IC is acceptable for IOE, combining IC and FS is advised, especially in the setting of earlier NAC, to enhance accuracy for small metastatic foci.

BackgroundPleural effusion is a common clinical problem with varied etiologies. Timely diagnosis is essential for appropriate treatment. This study aimed to compare the diagnostic performance of brush cytology and imprint cytology, with histopathology, in pleural biopsy specimens obtained via thoracoscopy.MethodsThis prospective observational study included 96 patients with undiagnosed exudative pleural effusion undergoing medical thoracoscopy. Biopsy samples were analyzed by histopathology, brush cytology, and imprint cytology. Diagnostic metrics, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), McNemar’s test, receiver operating characteristic (ROC) analysis, and logistic regression, were computed.ResultsImprint cytology demonstrated higher sensitivity (73.17%) and NPV (76.60%) compared to brush cytology (65.85% and 72.00%, respectively). Logistic regression showed that a positive imprint result predicted biopsy positivity with an odds ratio of 5.17. ROC analysis confirmed superior diagnostic performance for imprint cytology.ConclusionImprint cytology is a reliable, rapid, and effective diagnostic tool in thoracoscopic pleural biopsy evaluation, with performance metrics approaching those of histopathology.

Abstract Over the course of one year, a total of 1,944 stomachs from fattening pigs were examined. Upon macroscopic detection of pathological lesions, corresponding tissue samples were subjected to histopathological evaluation. In the non-glandular region of the stomach (pars esophagea), a 48% prevalence of pre-ulcerative and ulcerative lesions was recorded. Inflammatory changes were subsequently identified in 56% of cases, predominantly in the fundic region. Imprint cytology revealed the presence of Helicobacter spp. bacterial rods in the fundic mucosa. These findings suggest that gastric pathology in fattening pigs frequently extends beyond the pars esophagea, indicating a more complex and widespread involvement of the stomach.

Sentinel lymph node biopsy (SLNB) has become the gold standard for axillary staging in early-stage breast cancer, significantly reducing the morbidity associated with full axillary lymph node dissection. This study represents the first systematic evaluation of SLNB in a Libyan patient population, with integration of multimodal pathological assessment and hormonal profiling. Twenty women with histologically confirmed invasive breast carcinoma underwent SLNB at Alhelal and Alzuhor University Hospitals between 2023 and 2025. Intraoperative touch imprint cytology, hematoxylin and eosin staining, and pancytokeratin immunohistochemistry were performed to detect nodal metastasis. SLN metastasis was observed in four patients (20%), with macrometastases identified in three and micrometastasis in one case—detected only by immunohistochemistry. Hormonal receptor analysis showed heterogeneity, with strong ER/PR positivity in the micrometastatic case. These findings underscore the essential role of immunohistochemistry in nodal staging and align with regional and international data.

Sentinel lymph node (SLN) evaluation is central to breast cancer management. Intraoperative touch imprint cytology (TIC) and frozen section (FS) are standard, rapid techniques; however, their performance compared to the gold standard of histopathology in Sri Lanka is underreported. This study evaluates the validity of intraoperative TIC and FS in identifying SLN metastases in patients with breast cancer. We retrospectively analysed 416 SLN biopsies (2018-2020), with all cases assessed by TIC, FS, and subsequent paraffin histology. Demographic and clinicopathologic features were correlated with diagnostic metrics. Mean patient age was 55.9 years. Tumour sizes were ≤20 mm in 23.6%, 21-50 mm in 66.6%, and ≥50 mm in 9.9%. Most cases (92.1%) were invasive carcinoma of no special type (NST). Sensitivity and specificity for TIC were 90.6% and 100%; for FS, 92.7% and 100%. Combined TIC+FS yielded a sensitivity of 92.7% and a specificity of 100%. Detection rates for micrometastases were lower, and sensitivity for TIC was reduced in cases of lobular carcinoma and those where no LVI was found in the primary tumour. Both TIC and FS individually showed high sensitivity (90.6% and 92.7%, respectively) and perfect specificity (100%) in the detection of metastatic deposits in SLNs. Combining TIC and FS maintained excellent specificity, while also maintaining the same sensitivity as FS alone. All three methods demonstrated consistently strong predictive values and overall accuracy, with limitations for smaller deposits and specific subtypes, such as invasive lobular carcinoma.

Breast-conserving surgery (BCS) is a standard treatment for breast cancer, but achieving clear negative margins to avoid re-excision remains a challenge. Current intraoperative margin assessment techniques, such as frozen section analysis and imprint cytology, are limited by resource demands and workflow integration challenges. This study explores the physical design considerations for a handheld intraoperative imaging probe to assess tumor cavity margins during BCS. Data were collected through 9 surgical observations, 11 semi-structured interviews with breast surgeons, and interdisciplinary team meetings. Inductive thematic analysis identified key design priorities, including ergonomic handling, flexible probe tips, consistent tissue contact, and compatibility with both direct and tunneled access. Surgeons emphasized the need for quick scanning times and binary margin outputs, with interest in supplementary real-time imaging. These findings offer foundational insights for the iterative development of a clinically viable margin assessment tool aimed at reducing re-excisions and improving surgical outcomes in breast cancer care.

Background: Frozen section and intraoperative cytology examinations for musculoskeletal tumors are quite necessary, mainly to find out whether a representative specimen can be obtained for a definite diagnosis. Apart from that, it can also be done to determine the radicality of the surgery However, intraoperative pathological examination in musculoskeletal tumours cases as a difficult diagnostic interpretation, one of which may be due to the morphological features of some musculoskeletal tumors are being difficult to differentiate. Aim: To determine the diagnostic accuracy of frozen section and histopathological examination of musculoskeletal tumors. Methods: This study uses a retrospective diagnostic test method which presents the accuracy of frozen section examination compared with histopathological examination as the gold standard in musculoskeletal tumors by determining the sensitivity, specificity, ppv, npv. diagnostic accuracy of musculoskeletal tumors in the Anatomical Pathology Laboratory of Dr. Saiful Anwar Hospital Malang Results: The diagnostic accuracy of frozen section and histopathology examination is 96% with a sensitivity value of 93%, specificity 100%, npp 100%, npn 91.6%. The diagnostic accuracy of imprint cytology and histopathology is 93.7% with a sensitivity value of 93%, specificity 100%, npp 100%, npn 83.3%. The accuracy of intraoperative frozen section and cytology examinations may be influenced by the pathologist's experience, sampling techniques, tissue processing preparations, and the characteristics of the tumor cells themselves. Conclusion: Intraoperative pathological examination can primarily be used to ensure adequate specimens to support the diagnosis of muculoskeletal tumors. Keywords: frozen section; musculoskeletal tumor.

Lung cancer remains the leading cause of cancer-related mortality, often diagnosed at advanced stages, where minimally invasive tissue sampling is essential for diagnosis and molecular profiling. Rapid On-Site Evaluation (ROSE) enhances the diagnostic yield of small biopsies, but is frequently limited by a shortage of pathologists and logistical constraints. Telepathology offers a potential solution by enabling remote real-time assessment. This study evaluates the feasibility, diagnostic accuracy, and efficiency of telecytology-assisted ROSE (TC-ROSE) using touch imprint cytology (TIC) during CT-guided transthoracic core needle biopsy (CNB) of pulmonary nodules. 50 patients underwent CNB. TIC samples were assessed and evaluated on-site or remotely via a fully remote-controlled microscope system (OCUS®). TIC slide preparation was performed by pathologists (30 cases), radiologists (10), and trained assistants (10). The study analyzed diagnostic concordance between remote and on-site assessments, time efficiency, and the feasibility of involving non-pathologists in TIC preparation. Diagnostic samples were obtained in 86% of TIC samples, with full concordance (100%) between TC-ROSE and traditional ROSE. The slides required approximately 140 s for scanning, and the overall evaluation time was around 3 min per case. Overall, 100% of TICs were adequately assessed by both pathologists and non-pathologists. No increased number of complications was recorded among patients with TCROSE, compared to those ROSE evaluated. The remote setup allowed pathologists to maintain routine workflows, improving time efficiency. The findings confirm that telecytology is a viable, accurate, and efficient approach to ROSE, offering a practical solution for overcoming workforce and logistical barriers, particularly in settings with limited pathology resources.

Accurate intraoperative assessment of ovarian tumors is crucial for guiding surgical management. The objective of this systematic review and meta-analysis was to evaluate the diagnostic accuracy of imprint and scrape cytology for intraoperative risk stratification of ovarian tumors. A comprehensive literature search was conducted across multiple databases to identify studies that assessed the sensitivity, specificity, positive predictive value, and negative predictive value of imprint and scrape cytology in distinguishing benign and malignant ovarian tumors. Data were pooled using a bivariate random-effects model. The methodological quality of included studies was assessed using the quality assessment of diagnostic accuracy studies 2 tool. In total, 34 studies comprising 3318 ovarian tumors were included in the current review. Analysis indicated that the pooled sensitivity of imprint cytology was 89%, whereas the pooled specificity was 92%. The positive and negative likelihood ratios, calculated using a random-effects model, were 8.47 (95% confidence interval [CI], 5.27-13.61) and 0.16 (95% CI, 0.12-0.21), respectively. The pooled diagnostic odds ratio was 63.42 (95% CI, 37.5-107.27). For scrape cytology, the pooled sensitivity and specificity were 89% and 97%, respectively. The positive and negative likelihood ratios were 21.05 (95% CI, 12.36-35.84) and 0.14 (95% CI, 0.09-0.22), respectively. The pooled diagnostic odds ratio was 180.46 (95% CI, 88.01-370.03). Both techniques demonstrated high diagnostic accuracy, and scrape cytology was particularly effective in detecting malignancies. Imprint and scrape cytology are valuable intraoperative diagnostic tools for ovarian tumor stratification, offering rapid and reliable results. Their integration into surgical decision making may enhance intraoperative management, particularly in resource-limited settings. Further studies with standardized protocols are needed to refine their clinical utility.

Management of axillary lymph nodes (ALNs) in breast cancer patients remains pivotal for staging and planning therapeutic strategies. However, In low-resource settings, achieving accurate axillary staging while avoiding overtreatment remains a challenge as the majority of patients present with advanced stage. In this prospective validation study, we assessed the efficacy of axillary ultrasound (AUS) combined with touch imprint cytology (TIC) for predicting negative axillary status in cT2-3 breast cancer patients. This study was a prospective, single-centre validation study conducted in the Breast and Endocrine Unit of the Department of Surgery and the Department of Pathology in a tertiary teaching hospital in central India from September 2022 to April 2024. Eligible participants included adult female patients (aged ≥ 18 years) with core needle biopsy-proven invasive breast cancer classified as cT2-3, cN0, and scheduled for primary surgical treatment. The primary outcomes were the Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of the AUS + TIC approach in predicting pathologically negative axillary status. AUS + TIC had a sensitivity of 100% (95% CI: 47.82%-100%), a specificity of 100% (95% CI: 91.19%-100%) and an overall accuracy of 100% (95% CI: 92.13%-100%). There were no false negatives. Our findings suggest that the combination of AUS + TIC provides a reliable technique with high diagnostic accuracy, sensitivity, and specificity for assessing ALN in low resource settings.

Introduction: Intraoperative cytology in ovarian tumours involves collecting cell samples from the ovarian sample sent during surgery and quickly examining them for diagnostic information. Frozen section provides rapid diagnosis to guide intraoperative patient management. The indications of frozen section are identification of tissue, evaluation of margins, and identification of lymph nodes metastasis. Materials and Methods: Intraoperative tissue from clinico-radiologically suspected ovarian tumour for frozen section taken and processed in Department of Pathology and Laboratory Medicine. Squash smear, scrape smear, and imprint smear were made. Three stains rapid May-Grünwald Giemsa, rapid papanicolaou (Pap), and rapid hematoxylin and eosin with expected turnaround time of <15 min were done. Intraoperative cytological smear (squash, scrape, and imprint smear) were correlated with frozen section and histopathology slide. Final assessment of intraoperative cytological smears for diagnostic accuracy was done using statistical study. The aim of this study was to evaluate comparative diagnostic utility of squash smear, scrape smear, and imprint cytology with frozen section in intraoperative ovarian tumour is the aim of study. Results: Sensitivity, specificity, and diagnostic accuracy for frozen and cytology were: sensitivity of frozen section, squash cytology, and scrape cytology was 91.67% in all three, whereas sensitivity of imprint was 87.5%. Specificity of frozen section, imprint cytology, squash cytology, and scrape cytology was 96.77%, 93.55%, 90.32%, and 90.32%, respectively, and accuracy was 94.55%, 90.91%, 90.91%, and 90.91%, respectively. Conclusion: Imprint, squash, and scrape cytology have similar sensitivity and specificity compared to frozen section in identifying the nature of lesion and can be an alternative to frozen section in resource stricken setting.

Metastatic sarcomas to the pancreas are extremely rare, with poor survival rates. Therefore, rapid diagnosis and differentiation from primary malignant tumors of pancreas thereby guiding the treatment is indispensable. Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) is the current diagnostic modality of choice for pancreatic tumor sampling with promising results. Definitive pathologic diagnosis requires adequate tissue for performing ancillary studies. We present a rare case of metastatic synovial sarcoma in the pancreas in an elderly male to endorse the utility of EUS-FNB with imprint cytology as a rapid and effective diagnostic tool.