Imprint cytology in laryngeal and pharyngeal tumours

OBJECTIVE: The aim of this study was to evaluate the role of cytology in providing a reliable diagnosis upon which the clinician can base further investigative or treatment strategies in patients with laryngeal and pharyngeal tumours. METHODS: Imprint cytology diagnoses from 174 patients were correlated with the histological result of a corresponding biopsy. RESULTS: We found that the imprint cytology proved to be a useful, quick and reliable method with complete diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive values of 97%, 96%, 100%, 100% and 92% respectively. CONCLUSION: Imprint cytology allows diagnostic statements in a shorter time than is possible with histological sections and proves a useful adjunct in evaluating laryngeal and pharyngeal lesions. The validity of the method depends on the care with which the specimen is sampled and on the experience of the investigator.     

Imprint cytology in the intraoperative diagnosis of malignant melanoma

Imprints were prepared from 73 pigmented skin lesions, 19 of which were diagnosed as malignant melanoma. The cytologic findings in malignant melanoma, large clusters of cells with loss of cellular cohesiveness and large pleomorphic nuclei, were positive in 17 of the 19 cases. In other malignant and benign pigmented lesions the few cells adherent to the glass showed characteristic cytologic features of the particular lesion. Imprint cytology seems to be a valuable adjunct to the examination of frozen sections for the intraoperative diagnosis of malignant melanoma.     

Imprint cytology of extraskeletal mesenchymal chondrosarcoma of the perineum: a case report

BACKGROUND: Extraskeletal mesenchymal chondrosarcoma (EMC) is an uncommon soft tissue tumor, occurring mainly in the lower limbs, meninges and retroperitoneum. EMC of the female genital tract is extremely rare, and the cytologic literature is scarce. CASE: A 43-year-old female with a growing perineal mass underwent excision of the tumor. Pathologic examination of the rumor revealed a characteristic two-cell pattern of primitive small cells and cartilaginous tissue. A diagnosis of EMC of the perineum was made. Imprint cytology from surgical material showed a cluster of small round cells with a focal hemangiopericytomalike arrangement and islets of cartilage. The cartilaginous cells reacted with S-100 protein immunocytochemically. CONCLUSION: The characteristic features of EMC, a hemangiopericytomalike arrangement of small cells and S-100-positive cartilaginous cells, may be helpful in diagnosing EMC and differentiating it from other perineal tumors.     

Imprint cytology of epithelioid angiomyolipoma in a patient with tuberous sclerosis. A case report

BACKGROUND: Angiomyolipoma composed predominantly of epithelioid cells has been referred to as epithelioid angiomyolipoma. As this subtype shows considerable cellular atypia, it may be erroneously diagnosed as malignant epithelioid tumor, such as renal cell carcinoma and hepatocellular carcinoma. So far, only one report describing the cytologic findings of epithelioid angiomyolipoma has been documented, and epithelioid angiomyolipoma occurring in the peritoneal cavity has not been reported. CASE: Eleven years after resection of a renal epithelioid angiomyolipoma in a 34-year-old male with tuberous sclerosis, a tumor appeared in the peritoneal cavity and three masses in the liver. The intraoperative smears imprinted from part of the peritoneal mass revealed many large, atypical cells. The well-preserved atypical cells showed abundant, round to polyhedral, granular cytoplasm. Bizarre, giant nuclei with hyperchromasia and huge nucleoli were occasionally seen. Intranuclear cytoplasmic inclusions and mitotic figures were occasionally observed. As the epithelioid cells were markedly pleomorphic, we could not rule out hepatocellular carcinoma, cytologically and histologically, in the intraoperative consultation. In permanent sections the tumor was composed predominantly of epithelioid cells showing an alveolar pattern or sheetlike arrangement. Mitotic counts were zero to one per 10 high-power fields. Immunohistochemically, the epithelioid tumor cells were positive for vimentin, alpha-smooth muscle actin and HMB-45, consistent with epithelioid angiomyolipoma. MIB-1-labeling index was 1.6%. CONCLUSION: When one sees atypical epithelioid tumor cells in a tuberous sclerosis patient during an intraoperative consultation, one must consider epithelioid angiomyolipoma.     

Imprint cytology of vacuum-assisted breast biopsy specimens: a rapid diagnostic tool in non-palpable solid lesions

Objective:  Imprint cytology provides a rapid preliminary diagnosis shortly after the completion of breast biopsy. This study aims to assess the validity of imprint cytology for the pre-operative diagnosis of non-palpable mammographic solid lesions excised by vacuum-assisted breast biopsy (VABB).
Methods:  Seventy-two women with non-palpable Breast Imaging Reporting and Data System 3 and 4 mammographic solid lesions without microcalcifications underwent VABB on the stereotactic Fischer's table with 11-G Mammotome vacuum probes. Imprint samples were examined (Diff-Quick stain, modified Papanicolaou stain and May-Grünwald–Giemsa). The cores were dipped into a CytoRich Red Collection fluid for a few seconds in order to obtain samples with the use of the specimen wash. After the completion of cytological procedures, the core was prepared for routine pathological study. The pathologist was blind to the preliminary cytological results. The cytological and pathological diagnoses were comparatively evaluated.
Results:  The sensitivity of the cytological imprints for cancer was 90%. The specificity of the method for cancer diagnosis was 100%. Two precursor lesions were present in the material: one case of atypical ductal hyperplasia, which was successfully detected, and one case of lobular neoplasia, which escaped detection. The cytological imprints were inadequate in four out of 72 cases (5.6%), but none of them were included within the malignant subgroup.
Conclusions:  Imprint cytology seems to be an important adjunctive tool in the management of patients with non-palpable mammographic solid lesions. Its very satisfactory sensitivity and optimal specificity could establish its use in general clinical practice.     

Imprint cytology of gastric mucosa biopsy--fast, simple and reliable method for detection of Helicobacter pylori infection

The aim of the study was to determine the value of gastric mucosa imprint cytology in the detection of Helicobacter pylori infection. A total of 182 biopsy specimens, from 182 randomly selected patients undergoing gastroscopy with gastric mucosa biopsy, were analyzed. Specimens were first submitted to slide imprinting and then formalin fixed for further routine histopathology. One-hundred and fifty-five specimens proved adequate for definitive comparison of the methods used for detection of Helicobacter pylori infection. Helicobacter pylori was detected by histopathology in 51 specimens and by cytology in 54 specimens. Agreement between the findings obtained by the two methods was recorded in 130 of 155 (83.1%) specimens. Positive cytology and negative histology findings were obtained in 14, and vice versa in 11 specimens. Gastric mucosa imprint cytology provides a useful method for the detection of Helicobacter pylori infection. The method is advantageous for being fast, simple and inexpensive. When the sample is obtained exclusively for confirmation of the presence of Helicobacter pylori infection, cytology reduces the time and cost of the procedure, at the same time providing data on morphological changes of gastric mucosa. Every finding suspect of malignant transformation of the mucosa can also be verified by histopathology because imprint manipulation causes no damage to the sample.     

Fine needle aspiration cytology in cutaneous and subcutaneous endometriosis

OBJECTIVE: To study the role of fine needle aspiration cytology (FNAC) in the diagnosis of cutaneous and subcutaneous endometriosis. STUDY DESIGN: We present 7 cases of endometriosis in abdominal wall, inguinal region and perineum diagnosed by FNAC. All cases were confirmed with histologic follow-up. Cytologic and histologic material was prepared using standard methods. RESULTS: The smears were highly cellular, showing a hemorrhagic background with hemosiderin-laden macrophages and sheets of epithelial and stromal cells. Occasionally, these cellular components were closely associated. CONCLUSION: FNAC is useful in the diagnosis of cutaneous and subcutaneous endometriosis, providing a rapid and accurate preoperative diagnosis.     

Imprint cytology of parathyroid tissue in relation to other tissues of the neck and mediastinum

OBJECTIVE: To retest the hypothesis that imprint cytology may be used to reliably diagnose parathyroid tissue and, if so, to ascertain whether accuracy in this technique may be easily attained. STUDY DESIGN: Imprint preparations from 15 parathyroid, 10 thyroid, 8 lymphoreticular and 2 adipose tissue specimens were assessed blindly by two pathologists, one of whom (pathologist B) had only limited experience with endocrine tissue imprint cytology. RESULTS: Both assessors consistently distinguished parathyroid and thyroid preparations from lymphoreticular and adipose tissue preparations. While there was occasional difficulty in distinguishing between parathyroid and thyroid preparations, this was usually attributable to the scanty nature of the preparations. No single cytologic feature allowed a distinction between parathyroid and thyroid tissue. However, by considering several relatively diagnostic features collectively, pathologist B showed an increase in specificity and sensitivity rates for distinguishing parathyroid from thyroid imprints from 82% to 100% and 57% to 83%, respectively. CONCLUSION: The high accuracy rates and rapid [table: see text] learning curve shown by imprint cytology in distinguishing between different neck or mediastinal tissue types, together with its time- and cost-cutting potential, support a role for the technique in the intraoperative diagnosis of parathyroid tissue.