Senthilvel, M (2018) Comparison results between imprint cytology, scrape cytology and biopsy in surface malignancies. Masters thesis, Thanjavur Medical College, Thanjavur.
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Abstract
INTRODUCTION: Origin of cytology dates back more than a century, for over 100 years the discipline of anatomical pathology, has centred on diagnostic histopathology. Diagnostic cytology is the science of interpretation of cells derived from human body, which either exfoliates freely from epithelial surface or removed from various sources by artificial means. A correct diagnosis helps in starting the specific therapy in time, thus reducing morbidity and mortality. Imprint and Scrape cytology are now rapid diagnostic tool in the armamentarium of clinician’s .Imprint and scrape cytology are simple and rapid techniques for diagnosis. Imprint is a touch preparation in which tissue is touched on the slide and it leaves behind its imprint in the form of cells on glass slide; studies are made after proper staining. Scrape cytology is performed by using sterile sticks on the lesion and studies done after slides prepared with staining. This study is undertaken with the aim that though biopsy is Gold standard, imprints and scrape cytology are a rapid, simple and easy technique for tissue diagnosis. This is an accurate diagnostic tool available to all practicing surgeon even in small hospitals and semi urban hospitals. AIMS & OBJECTIVES: To analyze the sensitivity and specificity of imprint and scrape cytology and thereby to evaluate its diagnostic utility in comparison with biopsy results. OBSERVATION: A total of 50 patients with clinically evident surface malignancies were studied. Out of the 50, 46 lesions proved to be malignant and 4 were benign. All lesions of the oral cavity were correctly diagnosed by scrape/imprint method. There were 5 cases of Ca Rectum of which 2 were misinterpreted as benign by scrape/imprint method while biopsy turned out to be Adenocarcinoma and 1 was benign lesion by all the three methods and two cases were malignant by all the three methods. There were 12 cases of cutaneous ulcers of which 2 were Benign and 10 were malignant by biopsy. But out of the 10 lesions, 1 lesion was misinterpreted as inflammatory by cytology but was proven by biopsy as SCC. 1 case of Soft tissue sarcoma Lt arm was proven by HPE as Pleomorphic Sarcoma but misdiagnosed as benign by scrape/imprint cytology. Out of the 6 Ca Breast cases, one biopsy proven Invasive Ductal Carcinoma was missed by cytology. 2 cases of Secondaries neck were studied of which 1 biopsy proven inflammatory lesion was misinterpreted by imprint cytology as malignant, while scrape cytology showed no evidence of malignancy. There was discordance in biopsy proven 4 cases between imprint and scrape cytology of which 3 were cases of Ca oral cavity SCC shown to be dysplasia by Imprint but malignant cells positive by Scrape cytology and 1 case of Ca Breast IDC was reported as inflammatory in Imprint, malignancy by scrape cytology. Among 50 cases, histological subtypes were conclusive by either of the cytological methods in 43 cases. Scrape cytology was found to be more useful for ulcerative lesions. CONCLUSION: • Scrape/Imprint cytology is a rapid, safe, simple & inexpensive method to diagnose suspicious malignant lesion. • If scrape / imprint is positive, we can proceed with next level of management (surgery if needed) without waiting for biopsy report. • It can be done in resource poor conditions and promote early diagnosis and referral to specialist care. • Allays anxiety due to shorter waiting period and aids in quick decision making. • Highly sensitive, hence can be used as a rapid screening test. • Comparable to HPE reports in 86% of cases, hence can be used as valuable tool in PHCs & district hospitals. • Minimal cellular distortion provides crisp cytological details.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Scrape cytology ; Imprint cytology ; Biopsy ; Squamous cell carcinoma ; Basal cell carcinoma ; Malignant melanoma ; Sensitivity ; Specificity. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Sep 2018 15:37 |
| Last Modified: | 10 Sep 2018 15:37 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/9494 |
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