The ePCWP was the reliable echocardiographic parameter to predict PCWP in primary and secondary MR and might also be useful in MR with atrial fibrillation. The ePCWP may have an incremental value in a clinical setting.

Objective: This study aimed to determine the reliability of imprint cytology (IC) for intraoperative diagnosis of pulmonary lesions. Methods:We reviewed 113 cases of pulmonary lesion resection for which a scratch imprint was made intraoperatively. We divided the specimens into two groups (benign and malignant) and compared the scratch IC-based diagnoses against the final histopathological diagnoses in each group for concordance. We also analysed those cases in which the scratch IC preparation was classified as inadequate. Results:The sensitivity, specificity, positive and negative predictive values, and accuracy of IC diagnoses among the patient cohort were 87.7% (72/82), 100% (7/7), 100% (72/72), 41.2% (7/17) and 88.8% (79/89), respectively. IC yielded some falsenegative results in terms of malignancy, although most of these imprints were of early cancer or cancer with mild cytological atypia. Five (41.6%) of 12 lesions for which the imprint was deemed inadequate were diagnosed histologically as granulomas with caseous necrosis. Conclusion: IC-based diagnoses of pulmonary lesions as malignant correspondedwell with the final histopathological diagnoses, but IC-based diagnoses of negative (ie, without malignant cells) were not as reliable. Thus, pathologists should recognise the limitations of IC, especially for identifying malignant lesions. Also, the possibility of latent bacterial infection in a granuloma with caseous necrosis indicates that an IC preparation deemed inadequate for diagnosis should not be ignored. K E Y W O R D Sgranuloma with caseous necrosis, imprint cytology, intraoperative diagnosis, pulmonary lesion

To address the diagnostic performance of scratch-imprint cytology (SIC), in this study we compared intraoperative diagnoses of pulmonary lesions between SIC and frozen section histology (FSH) for accuracy with respect to the final pathological diagnosis. We histologically divided 206 pulmonary lesions (resected surgically) into two groups (benign and malignant) and compared each intraoperative diagnosis by SIC and FSH with the final pathological diagnoses. We also examined the radiological existence of pure ground-glass opacity (GGO) nodules in each group. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 91.5%, 100%, 100%, 63.6%, and 92.6%, respectively for SIC, and 98.2%, 100%, 100%, 92.1% and 98.5%, respectively, for FSH. Thus, we concluded that diagnosis by SIC is reliable for malignancy, but not for benign lesions. All pure GGO nodules (19; 9.2%) were noninfectious and malignant with a high accuracy of FSH diagnosis (100%), in comparison with those of low accuracy with a SIC diagnosis (57.9%). SIC can be an appropriate intraoperative diagnostic tool where multiple cytotechnologists observe intraoperative SIC preparations scratched evenly across the whole lesion including the peripheral area of the mass. K E Y W O R D S equivocal diagnosis, frozen section diagnosis, intraoperative diagnosis, qualitative diagnosis, scratch-imprint cytology

Objective We assessed whether intraoperative squash cytology could provide surgeons with a qualitative diagnosis of brain lesions when frozen section diagnosis is equivocal. Methods The study included 51 lesions that were diagnosed intraoperatively as equivocal brain tumour on the basis of frozen section. We retrospectively classified the lesions into five groups according to the final histopathological diagnoses (I: malignant lymphomas; II: diffuse astrocytic and oligodendroglia tumours; III: pituitary adenomas, IV: metastatic carcinomas; V: others). We assessed the squash cytology features of Groups I–IV and of the specific lesion types, and compared features among the groups. Results The four groups differed in a range of salient cytomorphological features: lymphoglandular bodies in Group I (eight of nine cases), cytoplasmic fibrillary processes in Group II (six of eight cases), low‐grade nuclear atypia in Group III (seven of seven cases), and large nuclei (approximately 80 μm2) and nuclear crush artefacts in Group IV (seven of nine cases). Conclusion Findings of lymphoglandular bodies on intraoperative squash cytology can be considered characteristic of malignant lymphomas, while cytoplasmic fibrillary processes indicate diffuse astrocytic and oligodendroglial tumours. We conclude that squash cytology could yield a qualitative intraoperative diagnosis in over 25% of cases for which frozen section yields a diagnosis of equivocal brain tumour.

This study was designed to examine the relationship between occult neoplastic cells (ONCs) inside and outside harvested lymph nodes (intranodal/extranodal ONCs) and local recurrence in 30 patients who underwent curative resection of primary colorectal cancer. Among 10 patients with colon cancer (Dukes' A=1, Dukes' B=6 and Dukes' C=3), intranodal ONCs were positive in 1 patient (10.0%) and negative in 9 patients (90.0%), while extranodal ONCs were negative in all 10 patients (100.0%). There were no significant differences between the detection of intranodal or extranodal ONCs. Among 20 patients with rectal cancer (Dukes' A=4, Dukes' B=2 and Dukes' C=14), intranodal ONCs were positive in 5 (25.0%) and negative in 15 (75.0%), while extranodal ONCs were positive in 3 (15.0%) and negative in 17 (85.0%). There were no significant differences between the detection of intranodal or extranodal ONCs. These results suggest that patients with rectal cancer and extranodal ONCs should be followed-up carefully as a high-risk group for pelvic local recurrence. However, the prevalence of extranodal and intranodal ONCs was almost similar.