The Diagnostic Utility of Intraoperative Cytology in the Management of Ovarian Tumours

Vijayakumar, Ananthalakshmi

doi:10.7860/jcdr/2013/4853.3035

Cited by 9 publications

(11 citation statements)

References 9 publications

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“…Various studies have compared the diagnostic accuracy of SS and FS with final histopathological diagnosis. [12345678910111213] The benefits of intaoperative diagnosis by cytomorphology over FS have been described. SSs are less time-consuming, inexpensive, and lack freezing artefacts; various heterogeneous areas can be examined in little time and tissue loss can be avoided.…”

Section: Discussionmentioning

confidence: 99%

“…The possible reason for discordance between FS and HPE in mucinous tumors is associated with characteristics of these tumors such as larger sizes and presence of benign, borderline, and malignant components in the same tumor in contrast to serous tumors. [9101112] The sampling thus should be done from solid-looking areas of cystic neoplasms. In addition, metastatic tumors especially mucinous carcinomas maybe challenging in FS if there is inadequate clinical information and communication with the surgeon.…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative Scrape Cytology from Ovarian Masss Lesions: A Study of 81 Cases

Gupta

Singh

Bhatt

et al. 2019

J Cytol

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Background: Intraoperative evaluation of an ovarian mass is of crucial importance in its further management, accomplished by frozen section (FS) and scrape smear (SS) examination. Aim: To evaluate utility of SS over FS and to study scrape cytological features of a variety of ovarian neoplasms. Materials and Methods: The study comprised ovarian tumors studied over a period of 1 year (2014–2015) that were submitted for intraoperative assessment. SS and FS were examined and evaluated independently. The results were compared with final pathological diagnosis in each case, and cases with discordant diagnoses were reviewed. All the SSs of ovarian tumors were re-evaluated with Giemsa-stained smears, and cytological features were described. Results: The results of SS and FS were 100% concordant. On histopathology, of 81 cases, 43 were epithelial [(categorized further as serous, mucinous, or malignant mixed Mullerian tumor (MMMT)] along with subcategorization of benign, borderline, and malignant), 16 were germ cell (categorized as teratoma: mature/immature and yolk sac tumor), 11 were sex cord stromal tumors (fibroma, granulosa cell tumor, Sertoli–Leydig cell tumor), 8 cases were hemorrhagic cysts (torsion, endometroid, corpus luteal cyst, etc.), and 3 were metastasis. There were 61 benign, 2 borderline, and 18 malignant cases on FS and scrape. Combining all the values, sensitivity and specificity were 76% and 98.21%, respectively. The diagnostic accuracy in diagnosing malignant lesions was 91%. Conclusion: Adequate knowledge on cytohistological correlation of ovarian scrape cytology may phase out the use of cryostat in intraoperative diagnosis of ovarian neoplasms, and thus be a boon for resource-deprived settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intraoperative Scrape Cytology from Ovarian Masss Lesions: A Study of 81 Cases

Gupta

Singh

Bhatt

et al. 2019

J Cytol

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“…Vijayakumar [14] studied IOC in ovarian neoplasms using H&E staining and yielded 90% accuracy with the final histopathological diagnoses, while Shahid et al [15] used both Papanicolaou along with H&E and reported 95.8% diagnostic accuracy. Chang et al [16] used Liu's stain in adjunct with FS and noted 96% accuracy.…”

Section: Discussionmentioning

confidence: 99%

Role of Field Staining in the Cytological Assessment of Intraoperative Surgical Specimens

Ojha¹,

Jain²,

Meenai³

et al. 2018

Acta Cytologica

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Objective: To study the role of Field staining in scrape smears for intraoperative cytological (IOC) diagnosis. Specimens were assessed for categorizing among benign and malignant lesions, lymph node status, and adequacy of surgical cut margins as per specimen. Technique, adequacy, and quality were assessed along with comparison of cytological diagnosis with final histopathological diagnosis obtained on routine hematoxylin and eosin-stained slides. Study Design: A prospective observational study was conducted over a period of 1 year from November 2016 to October 2017 in the Department of Pathology of our Institute. Results: 50 cases were studied, and scrape smears were stained with Field stain. Results were satisfactory in terms of adequacy and attaining the objectives of the study. A diagnostic accuracy of 98% was observed with an average turnaround time of 5 min. A single case of low-grade glioma was found to be discordant. Conclusions: Use of Field staining for intraoperative cytological assessment of surgical specimens has 98% concordance with the final histopathological diagnosis and achieved the aim of the study. With its low costs, easy availability, short turnaround time, and simple technique, it will be helpful in IOC as an alternative to present techniques especially in financially constrained settings.

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“…[20] They suggested the value of frozen section of ovarian tumours also lies in establishing whether an ovarian tumour is primary or metastatic. [7] Intraoperative Cytology Techniques' Statistical Parameters Author Year Cases Sensitivity Specificity PPV NPV Overall Accuracy…”

Section: Discussionmentioning

confidence: 99%

Prospective Study on Comparison of Intraoperative Frozen Section and Cytological Techniques as Diagnostic Modalities of Ovarian Mass Lesions

Dwivedi¹,

Jaiswal²,

Singh³

et al. 2017

jemds

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BACKGROUNDFrozen section and cytology in gynaecological pathology have received less attention till date. This research focusses on indications and limitations of per-operative diagnostic techniques in pathology. Ovarian neoplasms are heterogeneous group of benign and malignant tumours classified on different cells of origin. Histopathology, however, remains the gold standard in tissue diagnosis. MATERIALS AND METHODSA descriptive study was conducted including 31 cases. Frozen section was performed on tissue specimens received in normal saline on thermo scientific HM525 cryostat. Simultaneous scrape and imprint smears were prepared and all slides stained with H and E, Giemsa and read by two independent pathologists. Results were then compared with histopathology of each case. RESULTSFrozen section in ovarian lesions showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy values of 85.7%, 100%, 100%, 87.5% and 92.9% respectively. Aspirate cytology showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy values of 40%, 100%, 100%, 62.5% and 70% respectively. Imprint cytology showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy values of 33.3%, 100%, 100%, 60% and 66.7%. CONCLUSIONComparison of intraoperative histology and cytology show that though cytology provides supporting information preoperatively, frozen section examination is more reliable in deciding extent of surgery in ovarian mass lesions.

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The Diagnostic Utility of Intraoperative Cytology in the Management of Ovarian Tumours

Cited by 9 publications

References 9 publications

Intraoperative Scrape Cytology from Ovarian Masss Lesions: A Study of 81 Cases

Intraoperative Scrape Cytology from Ovarian Masss Lesions: A Study of 81 Cases

Role of Field Staining in the Cytological Assessment of Intraoperative Surgical Specimens

Prospective Study on Comparison of Intraoperative Frozen Section and Cytological Techniques as Diagnostic Modalities of Ovarian Mass Lesions

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