Scrape Cytology Research Articles

Scrape cytology – Diagnostic tool in large intestinal tumors

: Gastrointestinal tumors, mainly esophagogastric and colorectal carcinomas constitute one of the major causes of morbidity and mortality worldwide. The early detection and treatment of gastrointestinal tumors has been shown to improve patient's survival significantly. The current study is carried out to know the efficiency of scrape cytology in diagnosis of large intestinal tumors by comparing with histopathological diagnosisThirty surgically removed large intestinal tumor specimens were studied. Scrapings were taken from representative areas of each specimen, spread on slides, stained with H/E and reported. The specimens were fixed in 10% formalin, grossed and routine histopathological processing was carried out, followed by staining with H/E, examined and reported. The diagnosis obtained by scrape cytology and histopathology was correlated and analyzedTotal 30 specimens were received and majority of them were of rectal tumors(20%) and sigmund colon tumors(20%), followed by rectosigmoid region tumors (17%). Over all the scrape cytology diagnosis showed concordance for 28 cases with histopathology diagnosis having diagnostic accuracy of 93.3%.:Scrape cytology is simple, rapid and economically feasible technique and can be useful as an adjunct for frozen section in intraoperative consultation.

Role of scrape cytology smear preparation in the diagnosis of ovarian masses-utility and pitfalls.

Scrape cytology technique is useful for rapid intraoperative diagnosis of ovarian mass lesions that acts as an adjunct to frozen section examination. Though ovaries can be accessed by laparoscopy and USG guided FNAC, there are controversial reports regarding the safety of these procedures. The present study has been designed to evaluate the role of scrape cytology in a variety of ovarian mass lesions. To study the cyto-morphology of ovarian mass lesions and to evaluate the role of scrape cytology technique in correctly diagnosing the ovarian lesions taking histopathological diagnosis as gold standard. This is a prospective observational study done on 61 ovarian mass lesions as received from the Obstetrics and Gynecology department of our Institution. Out of 61 cases, 58 (95.08%) cases were correctly diagnosed with respect to categorization and typing. The age ranged from 14 to 65 years with the mean age being 38.1 years. On histopathology, out of 61 cases, 39 (63.93%) were epithelial along with sub categorization of benign, borderline, and malignant, 13 (22.9%) were germ cell tumors, 5(8.19%) were sex cord stromal tumors, 3 (4.91%) were hemorrhagic cysts and the remaining 1 (1.63%) was massive ovarian edema. Thus, on comparing with histopathology, the sensitivity and specificity of scrape cytology technique were 93.55% and 96.67%, and the diagnostic accuracy was 95.08%. Scrape cytology of ovarian lesions can give quick and reliable results. Also, proper training of cytopathologists chiefly regarding the sampling technique, gross presentation of ovarian lesions and interpretation of scrape cytology smears is needed. Further studies to provide standard guidelines and reporting criteria will prove to be helpful.

CYTO-HISTOPATHOLOGICAL CORRELATION OF PREMALIGNANT AND MALIGNANT LESIONS OF THE ORAL CAVITY IN A TERTIARY CARE HOSPITAL

Objectives: Globally, oral cancer seems to be the sixth-utmost common cancer. Oral cancer is the chief among entire malignant tumors of men in the Indian subcontinent and squamous cell carcinoma is the commonest among all oral malignancies. Hence, in the present study, the utility of aspiration and scrape cytology in the screening and initial diagnosis of oral lesions, to confirm by histopathology, were studied. Methods: The enrolled patients underwent complete clinical history, examination, fine-needle aspiration cytology (FNAC), scrape cytological assessment, and histopathological observations at VIMSAR, Odisha. Cytological smears were stained with Diff-Quik and Papanicolaou stains. Cytological observations were interrelated with concluding histopathological identification. Results: There were 32 premalignant and 60 malignant lesions of the oral cavity. Overall 69.56% diagnostic accuracy of scrape cytology for numerous intraoral premalignant and malignant lesions was found. The most common site for premalignant lesions was in the buccal mucosa, and malignancy was the tongue. Among the malignant lesion, squamous cell carcinoma was major, constituting 86.66% of cases, and most of the patients were in the fifth decade. Risk factor, mostly tobacco exposure, was associated with 66.66% of cases of a malignant lesion. Conclusion: FNAC and scrape cytology were observed as precise convenient, simple, and economical in the initial diagnosis of pre-cancerous and cancerous lesions of the oral cavity.

Recognizing Histological Patterns in the Endometrial Scrape Cytology of Hysterectomy Specimens

Recognizing Histological Patterns in the Endometrial Scrape Cytology of Hysterectomy Specimens

A Rare Primary Mucocutaneous Presentation of Chronic Disseminated Histoplasmosis in an Immunocompetent Young Female: A Case Report

Classical Histoplasmosis also known as Darling’s disease is a systemic mycosis caused by dimorphic fungus, Histoplasma capsulatum var capsulatum and Histoplasma capsulatum var duboisii. It is an opportunistic fungal infection that usually affects immunocompromised patients. Though microbiology culture methods are the gold standard, scrape cytology and histopathology give a relatively rapid diagnosis. It may pose a diagnostic dilemma on histopathology and morphology needs to be carefully studied to rule out other differentials. We present a rare case of chronic disseminated histoplasmosis with primary mucocutaneous lesions in an immunocompetent young female patient. This study is ethically approved from the institute and due written consent for publication from the patient has been taken.

“UTILITY OF SCRAPE CYTOLOGY IN EARLY DIAGNOSIS OF ORAL CAVITY LESIONS- A STUDY OF 115 CASES AT A TERTIARY CARE CENTRE.”

Background: The oral squamous cell carcinoma (OSCC) is the most common cancer worldwide and constitute a major health problem in developing countries, representing the leading cause of death. The oral cavity can be involved by a variety of lesions. These can be benign, premalignant or malignant. The most common carcinogenic agents associated with oral cavity lesions are tobacco, alcohol and betel nut (pan). Aims and Objectives: 1. early detection of premalignant and malignant oral lesions. 2. To conrm the cytological ndings by histopathological examination scrapped smear from 115 cases of oral cavity lesions were prepared and stained with MG Materials and Methods: G and PAP for cytological examination. The specimen/ biopsy material from oral cavity was collected, xed in 10% formalin and stained with H&E for Histopathological examination. July 2021 to June 2022. Out of 115 cases 23 were non- ne Study period: Results: oplastic, 22 cases were premalignant (dysplasia) and 70 cases were malignant in cytological examination. Overall, the scrape cytology diagnosis was concordant with nal histopathological diagnosis in 109 cases out of 115 cases with diagnostic accuracy 94.78%. The sensitivity was 92.11% and specicity was 100%. Oral scrape cytology is a rapid, painless, safe, inexpensive method for screeni Conclusion: ng and can diagnose a large number of patients in a short time. This method can be used for mass screening of population.

Utility of Indigenous Cytology Technique in the Diagnosis of Oral Cavity Lesions using Normal Saline as a Processing Fluid: A Comparative Study.

Oral cancer is a major health problem in developing countries. Cytology has been widely accepted as a tool in the early diagnosis of cancer. To evaluate the diagnostic utility of four different cytology techniques, that is, modified brush cytology (BR) technique, brush cytology cytocentrifugation (BRCC) technique, modified scrape cytology (SR) technique, and scrape cytology cytocentrifugation (SRCC) technique and correlate the cytopathological diagnosis with the available histopathological diagnosis. It was a prospective observational study of oral cavity lesions conducted from January 2018 to December 2018 at a rural tertiary care referral institute. Smears prepared by four different techniques, that is, BR technique, BRCC technique, SR technique and SRCC technique were evaluated using a scoring system. Normal saline was used as a processing fluid for cytocentrifugation techniques, and the cytological diagnosis was compared with an available histopathological diagnosis for concordance. Twenty-seven cases of oral cavity lesions were analyzed. Squamous cell carcinoma (55.56%) constituted the most common lesion diagnosed by cytology. Total concordance was 95.65%. Brush cytology techniques were better technique than scrape cytology techniques. Cytocentrifugation techniques were better than modified brush cytology technique and modified scrape cytology technique and the values were statistically highly significant (P<0.0001). The utility of only normal saline as a processing fluid for cytocentrifugation may be considered an unexplored and prudent endeavor. This indigenously designed technique may be employed to improve the quality of cytological preparation for the evaluation of oral cavity lesions.

Scrape cytology and radiological solid size correlation can be used in the intraoperative management of subsolid lung nodules

The term radiologic subsolid lung nodule (SLN) represents a heterogeneous group of non-neoplastic and neoplastic lesions. Intraoperative evaluation (IO) is often required to differentiate and diagnose. The current study aims to investigate the feasibility and reliability of scrape cytology (SC) and radiologic solid size correlation for the IO diagnosis of SLNs. Sixty-eight patients with SLN signs were eligible to take part in the study due to intraoperatively prepared SC slides. We managed to complete the blind radiologic solid size measurement and cytologic evaluation retrospectively. Cases were grouped into three categories based on their cytological features: Group-0 (Benign), Group-1 (mild atypical features), and Group-2 (severe atypical features/unequivocally carcinoma). IO diagnoses were given by combining the radiologic solid size and cytological findings. Cytological features of Group-1 were observed in 100%, 93%, 32.5%, and 17% of the AIS, MIA, IA, and benign lesions, respectively. Cytological features of Group-2 were observed in 67.5%, and 7% of the IA and MIA, respectively. By combining cytology with radiologic solid size, 100%, 85%, 71%, and 83% of the AIS, IA, MIA, and benign lesions respectively were diagnosed correctly. Fifteen (15%) percent of the IA cases were underdiagnosed as MIA since their radiological solid sizes were less than 0.5cm with cytological features of Group-1. Conversely, 29% of the MIA cases were overdiagnosed as IA since their radiological solid sizes were greater than 0.5cm. SLNs should be handled with caution in terms of IO management. SC and radiologic solid size correlation both provide a practical and tissue-protecting approach for the IO evaluation of SLNs, ensuring a high consistency between IO and definitive diagnosis.

Localized intestinal cryptococcosis and co‐parasitism in a juvenile dog

AbstractAn 8.5‐month‐old, male, entire golden retriever presented for 6‐month history of large bowel diarrhoea and vomiting. Giardiasis was previously treated. Clinical signs recurred despite empirical antibiotics, food trials, probiotics and psyllium. Physical exam revealed circumferential cobblestone‐like rectal mucosa. Rectal scrape cytology was consistent with cryptococcosis. Latex cryptococcal agglutination test was consistently negative. Thoracic radiographs were normal. Notable abdominal ultrasound findings included jejunal and suspected mesenteric cystic lymphadenopathy and multifocal areas of submucosal thickening. Abdominal lymph node aspirates revealed lymphoid hyperplasia. Faecal sedimentation and floatation revealed few Alaria species eggs and many Coccidia oocysts, respectively. Patient was treated with fluconazole, sulfadimethoxine, Drontal Plus and subsequently developed pancytopenia secondary to sulphonamide therapy requiring hospitalization, and recovered with supportive care and discontinuation of drug. Patient's clinical signs, rectal palpation and sonographic features resolved with continued fluconazole therapy. This case demonstrates localized intestinal cryptococcosis based on cytology with negative latex cryptococcal agglutination test and pancytopenia secondary to sulphonamide therapy for co‐parasitism.

Utility of Scrape Cytology in Management of Ovarian Neoplasms: a Cross-sectional Study in a Tertiary Care Hospital of Eastern India.

Ovarian tumors are one of the most common gynecological neoplasms worldwide affecting women of all ages. As preoperative diagnosis is often inaccurate, intraoperative diagnostic modalities play indispensable role in management of ovarian tumors to avoid unnecessary extensive surgery. Although reliable, frozen section is highly expensive for resource-poor developing countries. Intraoperative cytological methods can help to overcome these limitations. The aim of this study was to evaluate the accuracy of scrape cytology in diagnosis of ovarian tumors. The freshly removed specimens of ovarian tumors sent without any fixative during the study period were included in this observational prospective cross-sectional study. Scraping was done from the most representative area of the cut surface of the tumor. Cytological smears were stained by hematoxylin-eosin method. All the cytological smears and corresponding histological sections were evaluated separately. Cytological interpretation was then compared with histological diagnosis to assess the diagnostic accuracy of scrape cytology. On histology, 66 cases were diagnosed as benign (60%), 5 cases as borderline (4.55%), and 39 as malignant (35.45%). Of these, 64 cases (58%) were of epithelial origin, 25 cases (22.7%) were of germ cell origin and 6 (5.45%) cases were categorized as sex cord-stromal tumor. Accuracy of scrape cytology in diagnosis of benign, borderline, and malignant ovarian tumors was found to be 95.45%, 40%, and 89.74%, respectively. Overall accuracy rate was 90.91%. Scrape cytology is a rapid, inexpensive yet effective tool to diagnose benign and malignant ovarian tumors with high diagnostic accuracy.

What is your diagnosis? Corneal scrape cytology from a horse.

What is your diagnosis? Corneal scrape cytology from a horse.

Evaluating diagnostic utility of PAS stained skin scrape cytology smear in clinically suspected superficial cutaneous mycoses: A simple yet unpracticed technique.

Background and Objectives:For fungal dermatitis, a wet Potassium Hydroxide (KOH) preparation of the skin scrapings forms the routine practice for diagnosis. This study was carried out to determine the diagnostic accuracy and to evaluate the value-added information of PAS-stained scrape cytology smear in evaluating the presence of fungal elements.Methods:This prospective study was carried out on the patients clinically diagnosed with superficial cutaneous mycoses. For each patient, a wet KOH preparation and one PAS-stained skin scrape cytology (SSC) smear was prepared.Results:Out of the 52 suspected cases of superficial cutaneous mycoses, 50 showed fungal elements on either or both the techniques. The presentation was Tinea cruris together with Tinea corporis in 21 cases (42%), isolated tinea cruris in 19 cases (38%), tinea corporis in 8 cases (16%), and tinea corporis with tinea manuum and onychomycosis in 2 cases (4%). KOH preparation was positive in 45 out of 50 cases (90%) and SSC was positive in 49 out of 50 cases (98%). The sensitivity, specificity, positive predictive value, and negative predictive value for PAS-stained SSC smear was 98%, 100%, 100%, and 66% and that for KOH preparation was 90%, 100%, 100%, and 28%, respectively. Fungal elements quantity was graded on SSC smear as 1+(5), 2+(19), 3+(19), 4+(6), and in one case, it was negative.Conclusion:Incorporation of the PAS-stained SSC smear for fungal dermatitis ensures more efficient and confident diagnosis and the slides are available for archivable studies.

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.

Comparison of two intraoperative examination methods for the diagnosis of sentinel lymph node metastasis in clinically early stage endometrial cancer: A Turkish Gynecologic Oncology Group Study (TRSGO-SLN-003)

ObjectiveThis study evaluated diagnostic accuracy of intraoperative sentinel lymph node (SLN) frozen section examination and scrape cytology as a possible solution for management of SLN positive patients. Study designClinically early-stage endometrial cancer patients who underwent SLN algorithm and intraoperative SLN examination were analyzed. Findings were compared with final pathology results and diagnostic accuracy of frozen section and scrape cytology were evaluated. ResultsOf the 208 eligible patients, 100 patients (48 %) had frozen section examination and 108 (52 %) had scrape cytology of the SLN. Intraoperative examination and final pathology were negative for metastasis in 187/208 (90 %) cases. The rest 21 cases had metastatic SLNs according to final pathology. 12 of 21 (57 %) metastases were classified as macrometastasis. Intraoperative examination of SLNs correctly identified 13 cases (true positive) and missed 8 cases (false negative). Five of 8 false negative cases had micrometastasis or isolated tumor cells. Considering identification of macrometastasis, sensitivity and negative predictive value were 85.71 % and 98.94 %, respectively, for the frozen section and 60.00 % and 98.15 %, respectively, for the scrape cytology. ConclusionFrozen section examination of SLN has higher sensitivity in detecting macrometastasis compared to scrape cytology and it could help the surgeon in decision for further lymphadenectomy intraoperatively.

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 &amp; 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.

Diagnostic Utility and Accuracy of Scrape Cytology in Evaluation of Neoplastic Lesions.

Background:Frozen section, intraoperative fine needle aspiration cytology (FNAC) and imprint cytology have been used traditionally by the surgical pathology laboratories for rapid intraoperative diagnosis of tumors. Scrape cytology is a modification of imprint cytology that involves lightly scraping or brushing cells from freshly cut surface of the surgically removed tumor specimens. The present study was carried out to evaluate the utility of scrape cytology in diagnostic evaluation of tumors.Material and Methods:A prospective study was carried out at a tertiary care teaching hospital in Central India. A total of 50 consecutively received specimens in the Department of Pathology and Laboratory Medicine with clinical or radiological suspicion of neoplasia were included in the study. Scrape smears were prepared from freshly cut surface of tumor specimens received unfixed or in 10% formalin.Results:Overall, the scrape cytology diagnosis was concordant with final histopathological diagnosis in 48 out of 50 cases with a diagnostic accuracy of 96%. The sensitivity was 90.9% (CI-58.72% to 99.77%) and specificity was 97.4%(CI-86.52% to 99.94%). Positive predictive value and negative predictive value were 90.91% and 97.44%, respectively.Conclusion:Scrape cytology is a cost-effective and reasonably accurate cytodiagnostic technique for rapid tumor diagnosis. Scrape cytology can be a useful supplementary tool to frozen section, and may be applied for rapid diagnosis where frozen section technique is not available. The material and knowledge obtained from scrape cytology of routinely received histopathological specimens can be utilized as a teaching material and may help unveil diagnostic cytopathological features of infrequent cytologically encountered lesions.

Unusual Presentations of Disseminated Cutaneous Rhinosporidiosis Masquerading as Tumour Like Lesions of Skin: A Clinicopathological Study

Introduction: Rhinosporidiosis is a chronic granulomatous infective disease caused by Rhinosporidium seeberi which primarily affects the mucosa of the nasal cavity. Cutaneous lesions are infrequent. However, disseminated cutaneous lesions with varied presentations are very rare in routine pathology practice. Aim: The study aimed to diagnose cutaneous lesions due to rhinosporidiosis on Fine-Needle Aspiration Cytology (FNAC) and to confirm the same by histology. Materials and Methods: This was a cross-sectional study. A total of 8 cases of disseminated cutaneous Rhinosporidiosis out of 815 cutaneous lesions were observed over five years, from September 2013 to October 2018, in Department of Pathology, VIMSAR, Burla. FNAC and scrape cytology of the lesions were performed and studied after Diff-Quik and H&amp;E stain. The lesions were excised and histopathological examination was done. Results: It was observed that the overall incidence of cutaneous rhinosporidiosis diagnosed on FNAC was very low (less than 0.1%) They were mainly seen in middle-aged males from low socio-economic status and rural areas. The skin lesions were mostly subcutaneous nodules, few wart-like growth and ulcerative growth, some of which were initially diagnosed as neurofibroma and squamous cell carcinoma. FNAC and histopathological examination helped to confirm the diagnosis of rhinosporidiosis in all cases. Conclusion: Disseminated cutaneous rhinosporidiosis has varied clinical presentations, mimicking other cutaneous lesions. Hence, proper diagnosis of the patient is necessary which can be achieved by FNAC and histopathology.

Role of Imprint and Scrape Cytology in Tumour and Tumour Like Lesions of Ovary

Role of Imprint and Scrape Cytology in Tumour and Tumour Like Lesions of Ovary

Development of an invasive ductal carcinoma in a contralateral composite nipple graft after an autologous breast reconstruction: a case report

BackgroundNipple-areola complex (NAC) reconstruction is a technique used in breast reconstructive surgery, which is performed during the final stage of breast reconstruction after total mastectomy of primary breast cancer. Composite nipple grafts utilizing the contralateral NAC are common; however, to our knowledge, there are no reports of new primary invasive ductal carcinoma development within the graft. Here, we describe one such case for the first time.Case presentationA 54-year-old woman was referred to us by the Department of Plastic and Reconstructive Surgery in our medical center for further evaluation of right nipple erosion. She had undergone total mastectomy of the right breast following a breast cancer diagnosis 15 years ago, at which time tumor biological profiling revealed the following: estrogen receptor (ER), positive; progesterone receptor (PgR), negative; and human epidermal growth factor receptor 2 (HER2), undetermined. She received adjuvant chemotherapy and endocrine therapy. She defaulted endocrine therapy for a few years, and 7 years after surgery, she underwent autologous breast reconstruction with a deep inferior epigastric perforator (DIEP) flap. In the following year, NAC reconstruction was performed using a composite graft technique. Seven years after the NAC reconstruction, erosion appeared on the nipple grafted from its contralateral counterpart; scrape cytology revealed malignancy. The skin on the right side of her chest around the NAC and subcutaneous fat tissue consisted of transferred tissue from the abdomen, as the DIEP flap and grafted nipple were located on the graft skin. The right nipple carcinoma arose from the tissue taken from the left nipple. Magnetic resonance imaging (MRI) or computed tomography showed no malignant findings in the left breast. As the malignant lesion seemed limited to the area around the grafted right nipple on MRI, surgical resection with sufficient lateral and deep margins was performed around the right nipple. Pathological findings revealed invasive ductal carcinoma with comedo ductal components infiltrating the graft skin and underlying adipose tissue. Immunohistochemistry revealed positive for ER, PgR, and HER2.ConclusionsTo our knowledge, this is the first case involving the development of invasive ductal carcinoma in a nipple graft constructed on the skin of a DIEP flap, with the origin from the contralateral breast’s nipple.

Tobacco related oral cavity lesions, scrape cytology with histopathological correlation: A 5 year study at tertiary level hospital in Mumbai

Tobacco related oral cavity lesions, scrape cytology with histopathological correlation: A 5 year study at tertiary level hospital in Mumbai - IJPO- Print ISSN No: - 2394-6784 Online ISSN No:- 2394-6792 Article DOI No:- 10.18231/j.ijpo.2020.024, Indian Journal of Pathology and Oncology-Indian J Pathol Oncol