Intraoperative Diagnosis of Neoplastic Lesions by Imprint Cytology and Frozen Section with Histopathological Correlation

Abstract

Introduction: Intraoperative consultation examinations are required by surgeons from pathologists for immediate important decisions regarding the optimal extent of surgery. Surgeons particularly want to know whether a lesion is malignant or not. Both frozen section (FS) and touch impression cytology serve this purpose well. Both provide accurate results in minutes while the patient is under anesthesia. The surgeon then modifies his surgical plan based on the intraoperative consultation from pathologist. Objectives: The objective of this study is to access the role of imprint cytology (IC) and FS in diagnosis of tumors of different organs, to correlate IC and FS findings with histopathological diagnosis and to determine their diagnostic accuracy. Materials and Method: This present prospective cross-sectional study was done in the pathology department of BKL Walawalkar Rural Medical College, Dervan, Chiplun, for a period of one and a half year. A total of 161 surgical specimens from various organs were studied using IC and FS. The results of both the techniques were compared with the gold standard histopathological diagnosis. Results: Statistical correlation of IC and FS with histopathology shows that true positive cases on IC are 88.7% and on FS are 85.1%. Sensitivity, specificity, and diagnostic accuracy of IC and FS are 95.7%, 81.8%, 94.7% and 93.2%, 78.9%, 92%, respectively. Combined diagnostic accuracy is 93.5%. Conclusion: IC and FSs are interdependable intraoperative diagnostic modalities. IC is a simple, accurate, rapid, and cost-effective diagnostic tool, intraoperatively. FS preserves crisp cellular and nuclear detail and also closely approximates permanent histopathology sections. Thus, a combination of IC and FS helps in achieving high diagnostic accuracy rates and in distinguishing benign and malignant lesions.