Comparative Diagnostic Utility of Squash, Scrape, and Imprint cytology in Intraoperative Diagnosis of Ovarian Tumours

Introduction: Intraoperative cytology in ovarian tumours involves collecting cell samples from the ovarian sample sent during surgery and quickly examining them for diagnostic information. Frozen section provides rapid diagnosis to guide intraoperative patient management. The indications of frozen section are identification of tissue, evaluation of margins, and identification of lymph nodes metastasis. Materials and Methods: Intraoperative tissue from clinico-radiologically suspected ovarian tumour for frozen section taken and processed in Department of Pathology and Laboratory Medicine. Squash smear, scrape smear, and imprint smear were made. Three stains rapid May-Grünwald Giemsa, rapid papanicolaou (Pap), and rapid hematoxylin and eosin with expected turnaround time of <15 min were done. Intraoperative cytological smear (squash, scrape, and imprint smear) were correlated with frozen section and histopathology slide. Final assessment of intraoperative cytological smears for diagnostic accuracy was done using statistical study. The aim of this study was to evaluate comparative diagnostic utility of squash smear, scrape smear, and imprint cytology with frozen section in intraoperative ovarian tumour is the aim of study. Results: Sensitivity, specificity, and diagnostic accuracy for frozen and cytology were: sensitivity of frozen section, squash cytology, and scrape cytology was 91.67% in all three, whereas sensitivity of imprint was 87.5%. Specificity of frozen section, imprint cytology, squash cytology, and scrape cytology was 96.77%, 93.55%, 90.32%, and 90.32%, respectively, and accuracy was 94.55%, 90.91%, 90.91%, and 90.91%, respectively. Conclusion: Imprint, squash, and scrape cytology have similar sensitivity and specificity compared to frozen section in identifying the nature of lesion and can be an alternative to frozen section in resource stricken setting.