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Comparative study of intra-operative cytology, frozen sections, and histology of tumor and tumor-like lesions of nose and paranasal sinuses.

Nigam J, Misra V, Dhingra V, Jain S, Varma K, Singh A - J Cytol (2013)

Bottom Line: Thirty cases were included in this study.Cytological smears were prepared by imprint/squash methods from the representative tissue pieces and stained with Leishman-Giemsa and Papanicolaou.Imprint smears had better specificity as cells morphology could be more accurately appreciated.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, M.L.N. Medical College Allahabad, Uttar Pradesh, India.

ABSTRACT

Background: The nasal cavity and paranasal sinuses - including the maxillary, ethmoid, sphenoid, and frontal sinuses are collectively referred to as the sinonasal tract. Fine needle aspiration (FNA) of paranasal sinus lesions for early diagnosis of neoplastic lesions is difficult due to closed architecture, and only one study has been documented in the literature.

Aims: To find the efficacy of intra-operative cytology and frozen section for frequently encountered tumor and tumor-like lesions of the nose and paranasal sinuses.

Materials and methods: Thirty cases were included in this study. The material for cytologic examination and frozen sections were taken per-operatively. Cytological smears were prepared by imprint/squash methods from the representative tissue pieces and stained with Leishman-Giemsa and Papanicolaou. Frozen section and paraffin-embedded section were stained with hematoxylin and eosin stain. A rapid opinion regarding the benign or malignant nature of the lesion and the type of tumor was given.

Results: The sensitivity, specificity, and positive predictive value of imprint cytology, squash cytology, and frozen section were 100%, 100%, and 100%; 100%, 96.15%, and 80.0%; and 100%, 96.15%, and 80.0%, respectively. Overall diagnostic accuracy of imprint smears, squash smears, and frozen section was100%, 96.7%, and 96.7%, respectively. Imprint smears had better specificity as cells morphology could be more accurately appreciated.

Conclusions: Intra-operative cytology and frozen section examinations of lesions of nose and paranasal sinuses are useful, quick, and reliable diagnostic technique for rapid diagnosis in the operation theatre and can be used as an adjunct to histopathology for better management of patients.

No MeSH data available.


Related in: MedlinePlus

(a) Imprint from a nasal polyp showing clusters of columnar epithelial cells (Giemsa, ×400), (b) Polyp with pseudo stratified squamous epithelial lining with edematous stroma (Paraffin block; H and E, ×100); (c) Imprint from angiofibroma showing columnar epithelial cells, endothelial cells and fibroblasts (Giemsa, ×400); (d) Numerous thin walled blood vessels with fibrous stroma (Frozen section; H and E, ×100)
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Figure 1: (a) Imprint from a nasal polyp showing clusters of columnar epithelial cells (Giemsa, ×400), (b) Polyp with pseudo stratified squamous epithelial lining with edematous stroma (Paraffin block; H and E, ×100); (c) Imprint from angiofibroma showing columnar epithelial cells, endothelial cells and fibroblasts (Giemsa, ×400); (d) Numerous thin walled blood vessels with fibrous stroma (Frozen section; H and E, ×100)

Mentions: Non-neoplastic lesions were seen in 12 males and 8 females in age group of 11-50 years. All cases were described as non-neoplastic lesion on imprint [Figure 1a] and squash cytological smear technique using Giemsa stain. In imprint smears, one case had markedly increased cellularity of pseudo stratified epithelial cells suggestive of epithelial hyperplasia and in 4 cases along with columnar cells, clusters of squamous epithelial cells were also seen, which was suggestive of squamous metaplasia. One case showed few large hyperchromatic atypical cells, leading to suspicion of neoplastic lesion in squash smear.


Comparative study of intra-operative cytology, frozen sections, and histology of tumor and tumor-like lesions of nose and paranasal sinuses.

Nigam J, Misra V, Dhingra V, Jain S, Varma K, Singh A - J Cytol (2013)

(a) Imprint from a nasal polyp showing clusters of columnar epithelial cells (Giemsa, ×400), (b) Polyp with pseudo stratified squamous epithelial lining with edematous stroma (Paraffin block; H and E, ×100); (c) Imprint from angiofibroma showing columnar epithelial cells, endothelial cells and fibroblasts (Giemsa, ×400); (d) Numerous thin walled blood vessels with fibrous stroma (Frozen section; H and E, ×100)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643355&req=5

Figure 1: (a) Imprint from a nasal polyp showing clusters of columnar epithelial cells (Giemsa, ×400), (b) Polyp with pseudo stratified squamous epithelial lining with edematous stroma (Paraffin block; H and E, ×100); (c) Imprint from angiofibroma showing columnar epithelial cells, endothelial cells and fibroblasts (Giemsa, ×400); (d) Numerous thin walled blood vessels with fibrous stroma (Frozen section; H and E, ×100)
Mentions: Non-neoplastic lesions were seen in 12 males and 8 females in age group of 11-50 years. All cases were described as non-neoplastic lesion on imprint [Figure 1a] and squash cytological smear technique using Giemsa stain. In imprint smears, one case had markedly increased cellularity of pseudo stratified epithelial cells suggestive of epithelial hyperplasia and in 4 cases along with columnar cells, clusters of squamous epithelial cells were also seen, which was suggestive of squamous metaplasia. One case showed few large hyperchromatic atypical cells, leading to suspicion of neoplastic lesion in squash smear.

Bottom Line: Thirty cases were included in this study.Cytological smears were prepared by imprint/squash methods from the representative tissue pieces and stained with Leishman-Giemsa and Papanicolaou.Imprint smears had better specificity as cells morphology could be more accurately appreciated.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, M.L.N. Medical College Allahabad, Uttar Pradesh, India.

ABSTRACT

Background: The nasal cavity and paranasal sinuses - including the maxillary, ethmoid, sphenoid, and frontal sinuses are collectively referred to as the sinonasal tract. Fine needle aspiration (FNA) of paranasal sinus lesions for early diagnosis of neoplastic lesions is difficult due to closed architecture, and only one study has been documented in the literature.

Aims: To find the efficacy of intra-operative cytology and frozen section for frequently encountered tumor and tumor-like lesions of the nose and paranasal sinuses.

Materials and methods: Thirty cases were included in this study. The material for cytologic examination and frozen sections were taken per-operatively. Cytological smears were prepared by imprint/squash methods from the representative tissue pieces and stained with Leishman-Giemsa and Papanicolaou. Frozen section and paraffin-embedded section were stained with hematoxylin and eosin stain. A rapid opinion regarding the benign or malignant nature of the lesion and the type of tumor was given.

Results: The sensitivity, specificity, and positive predictive value of imprint cytology, squash cytology, and frozen section were 100%, 100%, and 100%; 100%, 96.15%, and 80.0%; and 100%, 96.15%, and 80.0%, respectively. Overall diagnostic accuracy of imprint smears, squash smears, and frozen section was100%, 96.7%, and 96.7%, respectively. Imprint smears had better specificity as cells morphology could be more accurately appreciated.

Conclusions: Intra-operative cytology and frozen section examinations of lesions of nose and paranasal sinuses are useful, quick, and reliable diagnostic technique for rapid diagnosis in the operation theatre and can be used as an adjunct to histopathology for better management of patients.

No MeSH data available.


Related in: MedlinePlus