Online ISSN: 2515-8260

“Assessment of lymph node status in cases of metastatic malignancy by frozen section and imprint cytology”

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1. Dr Miheer Milind Jagtap,2. Dr Samarth Shukla,3. Dr Sunita Vagha4. Dr Ankita Tamhane,5. Dr Sourya Acharya,


Abstract: Introduction: Dissemination of cancers most commonly occurs by the lymphatic route and is generally favoured by carcinomas. The best achievable goal of any surgical procedure is removal of all the affected tissue and leave behind healthy tissue which is entirely free of any malignant cells. Though histopathological examination is gold standard, it is time consuming and cannot be implemented as an intraoperative diagnostic tool. The present study utilises frozen section analysis and touch imprint cytology as intraoperative tools and analyses their diagnostic accuracy to detect lymph node metastasis in comparison with routine histopathology in epithelial malignancies. Aim: To evaluate the efficacy of intraoperative diagnosis by touch imprint cytology and frozen section analysis for the assessment of metastatic lymph node deposits. Materials and methods: Total 76 cases of primary malignancy with suspicious metastatic lymph nodes were investigated. Metastatic nodes were subjected to frozen section and touch imprint cytology and these findings were compared with routine histopathology and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. Results: The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of frozen section was found to be 97.30%, 100%, 100%, 97.5% and 98.68%. The values of the same parameters for imprint cytology was found to be 75.68%, 100%, 100%, 81.25% and 67% respectively. Conclusions: Frozen section analysis proved superior to imprint cytology in detecting lymph node metastasis intraoperatively. Apart from detecting the presence of metastasis, frozen section is able to provide details regarding micro-metastasis, macro-metastasis and perinodal fat invasion. This study predominantly evaluated epithelial malignancies and thus proves the utility of these two intraoperative modalities in them. It also opens new avenues for research pertaining to the utility of these modalities in various malignant mesenchymal tumours.

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