Evaluation of Intraoperative Imprint Cytology and Frozen Section in Determination of Tumor and Tumor Margins

Abstract

Intraoperative pathology consultation is often required for guiding immediate surgical decisions so as to limit the extent of surgery. Accurate intraoperative diagnosis is crucial. The present study evaluates the accuracy of imprint cytology and frozen section in intraoperative consultation for tumor and tumor margins. A total of 157 tissue specimens for type of lesion, tumor margins and lymphnode metastasis were included. Imprint was taken by holding the tissue bit with forceps and touching it onto a clean glass slide without undue pressure or lateral movements. They were stained with Papanicolaou, May-Grunwald Giemsa and Hematoxylin and Eosin [H&E] stains. The tissue bits taken were then embedded and frozen. Section cutting was done using cryostat and were stained using rapid Haematoxylin and Eosin stain, and examined under a light microscope. Later, the tissue was fixed in 10% neutral buffered formalin for routine histopathological processing then stained with H&E stain. Based on the histological diagnosis, the accuracy of intraoperative imprint cytology and frozen section were evaluated. A total of 157 tissue specimens were received during the study period, which were classified into specimens for type of tumor [145 specimens], tumor margins [54 specimens] and lymph node metastasis [7 specimens] for analysis. The overall diagnostic accuracy of imprint cytology in detection of type of tumor was 97.9% and that of frozen section was 98.6%. It can be concluded that imprint cytology typically provides the accurate diagnosis without the need for a sophisticated machine such as cryostat which is required for frozen section analysis.