Advancing cytohistological techniques in the bronchoscopic suite: Imprint Smears versus Frozen Section

<bold>Introduction:</bold> The absence of comparative data between imprint cytology(IC) and frozen section (FS) analysis in diagnosing lung malignancies from bronchoscopic biopsy specimens highlights a critical diagnostic gap. <bold>Aim:</bold> The study aimed to compare the efficacy, duration, and economic advantages of imprint cytology, (IC) against frozen section (FS) and the gold standard, routine histopathology, emphasizing its utility in settings lacking frozen section facilities. <bold>Methods:</bold> We analyzed 64 bronchoscopic forceps biopsy specimens from adult patients at a tertiary care hospital in Eastern India over one year. Each specimen was subjected to IC, FS analysis, and histopathology. Sensitivity, specificity, and the duration of the modalities were calculated. <bold>Results:</bold> For malignancies, IC achieved a sensitivity of 76.9% and a specificity of 100%, while FS analysis showed a sensitivity of 92.3% and a specificity of 100%. For benign lesions, IC sensitivity was 32% with a specificity of 68%, compared to FS, which had a sensitivity of 44% and a specificity of 56%. Overall the diagnostic accuracy for IC was 84.2%, and for FS, it was 94.9%. The average procedure time was notably shorter for IC at 11.2 min vs 28.4 min for FS analysis. This reduction in procedure time, along with effective specimen triage, highlights the economic efficiency and rapidity of IC. <bold>Conclusion:</bold> Imprint cytology is a quick, reliable, and cost-effective method for diagnosing lung malignancies, suitable for settings without frozen section capabilities. However, given its superior sensitivity for malignancies, frozen section analysis should be the preferred choice when both options are available, ensuring optimal diagnostic accuracy.