Intraoperative cytology of ovarian neoplasms with an attempt to grade epithelial tumors

• Published in: Journal of cytology Vol. 35; no. 1; pp. 1 - 7
• Main Authors: Bohara, Sangita, Jain, Shyama, Khurana, Nita, Shangpliang, Darilin, Agarwal, Swapnil, Gandhi, Gauri
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-01-2018; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Cellular biology; Cysts; Cytology; Decision making; Diagnosis; Epithelial tumors; frozen; grading; Gynecology; Histology; Histopathology; intraoperative; Obstetrics; Original; ovarian; Ovarian cancer; Pathology; Preservation; Stains & staining; Toluidine; Tumors; intraoperative; frozen; grading; ovarian; Cytology
• ISSN: 0970-9371; 0974-5165
• DOI: 10.4103/JOC.JOC_183_16

Background: Intraoperative cytology (IOC) is a simple and quick technique with excellent preservation of cellular details. In the present study, we have evaluated the role of IOC by various methods of smear preparation and compared it with frozen section diagnosis. A scoring system was followed for epithelial tumors for characterization and grading on the basis of cellularity, pattern, nuclear, cytoplasmic features, and background details. Materials and Methods: The study was conducted during a time span of 2 years in total 48 cases of ovarian tumors. Fine-needle aspiration cytology, touch/imprint, scrape, and crush techniques were used. The smears so prepared were processed for toluidine blue and Giemsa and Papanicolaou staining. Cases were cytomorphologically categorized into four groups: Indeterminate; unequivocally benign; borderline tumor with equivocal morphology; and unequivocally malignant (graded into well, moderately, and poorly differentiated). Results: In our study, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 88.88, 96, 96, 88.88, and 92.31%, respectively, were recorded. This was comparable to frozen section diagnosis with a sensitivity, specificity, PPV, NPV, and accuracy of 85.18, 96.15, 95.83, 86.21, and 90.56%, respectively. In epithelial tumors, cytological grading correlated with histopathological grading in 85.29% cases of epithelial tumors. Conclusion: IOC gives comparable results to frozen section and can be used for intraoperative assessment of ovarian tumors. Grading of epithelial tumors on IOC can be performed and may become an important step in intraoperative decision-making for better management and outcome of the patient.