RESUMEN
Background: The ovaries frequently are the site for various primary tumors. Correct intraoperative diagnosis is crucial. The application of imprint cytology is very useful where frozen section facility is not available. The present study is a comparison of imprint cytology and frozen section during intraoperative consultation for various types of benign and malignant ovarian neoplasms in different age groups.Methods: Seventy-six cases of ovarian tumors were examined using both imprint cytology and frozen section and evaluated, taking histopathological report as gold standard. The histopathological diagnoses consisted of benign (54), borderline (9), and malignant (13). The malignant tumors consisted of various types including serous carcinoma, mucinous carcinoma, endometrioid carcinoma, clear cell carcinoma and carcinoid.Results: All 54 benign cases were accurately diagnosed as benign by imprint cytology. With frozen section 53 cases were correctly diagnosed as benign but one case was over diagnosed as borderline. Among 13 malignant cases 11 (84.6%) were correctly diagnosed with both techniques. Borderline tumors were not able to be diagnosed with imprint smear, 3 out of 9 cases were correctly diagnosed with frozen section.Conclusion: When compared with frozen section, imprint cytology is a simple, inexpensive and useful diagnostic tool in intraoperative diagnosis of benign and malignant ovarian tumors. Imprint smear is not useful in borderline tumors where only frozen section is useful. Imprint cytology can be used as an adjunct to frozen section for better diagnosis.
RESUMEN
Background: Abnormal uterine bleeding is one of the most common problem encountered in gynaecology clinics. Assessment of endometrial pathology is recommended to rule out malignancy and premalignant conditions. Endometrial sampling can be done by Pipelle biopsy in outpatient units as well as by conventional dilatation and curettage in an operation theatre setup. Our study aims to find out the efficacy of office endometrial biopsy in terms of its sample adequacy, diagnostic accuracy and patient acceptability.Methods: 120 women presenting with abnormal uterine bleeding were included. A detailed history along with clinical examination findings are entered in the proforma. Ultrasound scan was done for all of them to identify pelvic pathology and endometrial thickness. Endometrial sampling was then done with Pipelle without anaesthesia. Histopathology reports are collected and sample adequacy and pattern were analysed. Patients are subsequently followed up for a period up to one year. Those who underwent hysterectomy are analysed for the endometrial pathology in hysterectomy specimen which is used as gold standard and compared with Pipelle endometrial sampling histopathology.Results: Sample adequacy for Pipelle biopsy was found to be 96%. Diagnostic accuracy for atypical hyperplasia and adenocarcinoma is 92.5% and 94% respectively. In hysterectomy specimens, carcinoma endometrium coexisted with atypical hyperplasia in 40% of cases with atypical hyperplasia in pipelle biopsy report.Conclusions: Thus, Pipelle endometrial biopsy is a cost-effective method for endometrial sampling except for focal lesions.