Efficacy of Imprint Cytology over Histopathological Sections in Head and Neck Lesions

BACKGROUND: The technique of imprint cytology has provided great importance to cytodiagnosis due to its simple, cost effective, excellent cellular details and rapid results. While diagnosing malignant tumour it plays a significant role in avoiding multiple re-excisions for margin clearance and helps optimize cosmetic results in patients undergoing conservative surgery. OBJECTIVES OF THE STUDY: 1. To study the efficacy of touch imprint cytology as a diagnostic tool in identifying malignancies. 2. To correlate the diagnosis on touch imprint cytology with that of the histopathology. METHODOLOGY: A total of 57 surgically resected specimens from Head and neck lesions in DR. B. R. Ambedkar Medical College and hospital from November 2017 to June 2019 were evaluated. Imprint smears of freshly excised specimens before fixation in formalin were made by pressing the cut surface of tissue against the glass slide for suspicious foci. The Imprint slides were fixed in 95% ethyl alcohol and stained as per standard protocol using haemotoxylin and eosin (H& E) and papanicolaou (pap) stains. Diagnosis was made on detailed light microscopic examination and clinical information. RESULTS: The present study is prospective study with a total of 57 cases of head and neck lesions being studied. Predominantly encountered were non- neoplastic lesions of thyroid , followed by cervical lymph node, salivary glands and others. Imprint cytology diagnosis in comparison with HPE diagnosis had sensitivity of 87.5% with 100% specificity positive predictive values of 100% and negative predictive value of 95.35%. Overall diagnostic accuracy of detecting type of lesion was 96.49%. Kappa agreement between imprint cytology and HPE was 0.9097. CONCLUSION: The use of smear technique in intraoperative diagnosis provides a rapid and efficient means of pathological assessment. It is capable of obtaining a high degree of accuracy and hence, its use is highly recommended routinely. Key words: Imprint cytology, Thyroid neoplasm’s, Salivary neoplasm’s, Histopathology, Accuracy, Lymphadenopathies, Benign, Malignancy.