Usefulness of Intraoperative Imprint Cytology in Ovarian Germ Cell Tumors

Abstract

Objective: This study retrospectively investigated the usefulness of intraoperative diagnosis based on imprint cytology and frozen sections for ovarian germ cell tumor. Study Design: Intraoperative studies were reviewed for 23 cases with ovarian germ cell tumor treatment for which both frozen sections and imprint cytology were available. Final histopathologic diagnoses were compared with those based on intraoperative examinations. Results: Underlying pathologies included dysgerminoma (n = 6), yolk sac tumor (n = 1), non-gestational choriocarcinoma (n = 1), mature cystic teratoma with malignant transformation (n = 1), immature teratoma (n = 11), and mixed germ cell tumor (n = 3). Discrepancies between intraoperative imprint cytology and definitive histologic diagnosis were seen in 6 of the 23 cases. Accuracy was 54.5% (6/11) for immature teratoma and 91.7% (11/12) for other tumors. Cytologic examination facilitated accurate diagnosis in both of our cases, and intraoperative diagnosis by frozen section proved inaccurate. Conclusion: These results demonstrate that intraoperative assessment based on imprint cytology for immature teratoma has a relatively lower sensitivity, but an acceptable sensitivity for other germ cell tumors. Diagnostic approaches combining frozen sections and imprint cytology are advisable to improve the yield for intraoperative diagnosis.

Usefulness of imprint cytology of gonadoblastoma with dysgerminoma in a patient with Turner syndrome and a Y chromosome: A case report and literature review

“…Imprint cytology is reportedly useful in the diagnosis of ovarian germ cell tumors. 14 The imprint cytology of dysgerminoma is characterized as a so-called "two-cell pattern," containing atypical cells and lymphocytes. 14 Gonadoblastoma is not easily confused histopathologically with other gonadal neoplasms; the differential diagnosis includes sex cord tumors with annular tubules.…”

“…14 The imprint cytology of dysgerminoma is characterized as a so-called "two-cell pattern," containing atypical cells and lymphocytes. 14 Gonadoblastoma is not easily confused histopathologically with other gonadal neoplasms; the differential diagnosis includes sex cord tumors with annular tubules. The differential diagnosis of dysgerminoma, on the other hand, includes poorly differentiated carcinoma, diffuse large B-cell lymphoma, and embryonal carcinoma.…”

“…12 Despite discussion based on many retrospective studies, 10-12 the appropriate timing of prophylactic gonadectomy has not been established. 14 The imprint cytology of dysgerminoma is characterized as a so-called "two-cell pattern," containing atypical cells and lymphocytes. [11][12][13] Intraoperative imprint cytology of our patient's neoplasm revealed two characteristic types of cells consistent with histopathological findings, suggesting a tumor including elements of both gonadoblastoma and dysgerminoma.…”

Is Imprint Cytology Useful to Diagnose Malignancy for Brenner Tumors? A Case Series at a Single Institute

“…Previous studies have reported that imprint cytology of malignant ovarian tumors showed a high degree of nuclear atypia and highly cellular clusters [11,12] . Although these features were also observed in malignant Brenner tumors, nuclear grooves were not seen in other malignant ovarian tumors.…”

Abdominopelvic washings in gynecologic pathology: A comprehensive review

“…68 The cytomorphology of germ cell tumors varies with the type. 125 Dysgerminoma Dysgerminomas are the most common malignant germ cell tumor of the ovary, and comprise 1-2% of all malignant ovarian tumors. 124 Intraoperative imprint cytology may aid in the correct diagnosis of germ cell tumors as they allow for more thorough sampling of the tumor than a single frozen section.…”