Comparative study of intra-operative cytology, frozen sections, and histology of tumor and tumor-like lesions of nose and paranasal sinuses

Abstract

Background:The nasal cavity and paranasal sinuses - including the maxillary, ethmoid, sphenoid, and frontal sinuses are collectively referred to as the sinonasal tract. Fine needle aspiration (FNA) of paranasal sinus lesions for early diagnosis of neoplastic lesions is difficult due to closed architecture, and only one study has been documented in the literature.Aims:To find the efficacy of intra-operative cytology and frozen section for frequently encountered tumor and tumor-like lesions of the nose and paranasal sinuses.Materials and Methods:Thirty cases were included in this study. The material for cytologic examination and frozen sections were taken per-operatively. Cytological smears were prepared by imprint/squash methods from the representative tissue pieces and stained with Leishman-Giemsa and Papanicolaou. Frozen section and paraffin-embedded section were stained with hematoxylin and eosin stain. A rapid opinion regarding the benign or malignant nature of the lesion and the type of tumor was given.Results:The sensitivity, specificity, and positive predictive value of imprint cytology, squash cytology, and frozen section were 100%, 100%, and 100%; 100%, 96.15%, and 80.0%; and 100%, 96.15%, and 80.0%, respectively. Overall diagnostic accuracy of imprint smears, squash smears, and frozen section was100%, 96.7%, and 96.7%, respectively. Imprint smears had better specificity as cells morphology could be more accurately appreciated.Conclusions:Intra-operative cytology and frozen section examinations of lesions of nose and paranasal sinuses are useful, quick, and reliable diagnostic technique for rapid diagnosis in the operation theatre and can be used as an adjunct to histopathology for better management of patients.

Clinicopathological study of Sinonasal Masses

“…[6] Intraoperative cytology and frozen section examinations of lesions of nose and paranasal sinuses are useful, quick, and reliable diagnostic technique for rapid and early diagnosis in the operation theatre and can be used as an adjunct to histopathology for better management of patients. [7] The presenting features, symptomatology and advanced imaging technique help to reach a presumptive diagnosis but histopathological examination remains the mainstay of final definitive diagnosis. [8,9] The present study was carried to study the age and sex distribution of sinonasal masses, their clinical presentation and to categorize them histopathologically.…”

Comparação entre a citopatologia por biopsia com agulha fina e a histopatologia no diagnóstico das neoplasias cutâneas e subcutâneas de cães

“…O carcinoma de células escamosas foi o tumor epitelial mais encontrado, quando diagnosticado pela citopatologia. Este tumor foi diagnosticado com precisão através da avaliação citológica em cinco de quatro casos, corroborando com o descrito por Nigam et al (2013 outro lado, Ménard et al (1986) definiram os carcinomas escamosos como difíceis de diagnosticar devido a pouca celularidade, presença de restos necróticos e inflamação. Semelhantemente ao descrito por Magalhães et al (2001), a morfologia do carcinoma de células basais pode causar dificuldade para interpretação citopatológica, passível de erro com outros carcinomas.…”

“…Os resultados obtidos neste estudo confirmam os registros da literatura, que definem a citopatologia como um método seguro, rápido e eficaz na prática clínica, para diferenciação de lesões neoplásicas e não neoplásicas (Ghisleni et al 2006, Gupta et al 2011, Nigam et al 2013. A concordância entre os exames citopatológico e histopatológico para definir se o tumor era neoplásico ou não foi de 91,91%.…”

“…A citopatologia tem sido amplamente difundida e começou a ser mais utilizada devido a sua praticidade (Guedes et al 2000, Lavalle 2003. Nos neoplamas cutâneos e subcutâneos é possível realizar uma avaliação rápida, pouco invasiva e de baixo custo quando comparada a histopatologia (Rocha 2008, Nigam et al 2013. Diferentemente da citopatologia, o exame histopatológico permite a avaliação da arquitetura tecidual, que possibilita verificar se há perda da organização tecidual e a sua relação com os tecidos adjacentes, o que possibilita estabelecer se as células tumorais são invasivas ou não (Motosugi et al 2001).…”

Squash Cytology in Neurosurgical Practice: A Useful Method in Resource-Limited Setting with Lack of Frozen Section Facility

“…In fact, studies have shown that the use of intra-operative cytology has great value in providing diagnostic information when frozen section was equivocal or when frozen-section evaluation could not be done [e.g., excessively small sample] [17]. According to nigam et al, a well-prepared squash smear may eliminate the need for frozen section or at least influence its interpretation [18]. Further, elimination of freezing artifact [12] and reduced cryostat contamination from potentially infected tissue make squash cytology superior over frozen section [10].…”