The Role of Crush Cytology in the Diagnosis of Large-Intestine Lesions with Correlation on Histopathology

Chaithra GV, Debarshi Saha, Richa Yadav, Deepa S. Adiga, Flore D. Lobo, Apurv Ghosh, Jyoti Kini

Research output: Contribution to journalArticle

Abstract

Objective: To study the efficacy of colonoscopic crush cytology as a convenient and near-accurate method to evaluate colonic neoplasms. Study Design: Retrospective and cross-sectional. The original cytologic diagnoses were correlated with a histology report on 100 cases sent to the cytology laboratory over 2 years. Results: Of the 100 cases, 25 were nonmalignant. Of the 75 malignant lesions, 72 could be identified as positive for malignancy on cytology. The false-positives consisted of 6 adenomas and 1 case of ulcerative colitis. Thus, sensitivity and specificity of cytology are 96 and 63.2%, respectively. Of the 6 adenomas diagnosed as malignant, 4 showed high-grade dysplasia, and the other 2 showed superficial ulceration with low-grade dysplasia on histopathology. The ulcerative colitis case showed widespread ulcers and regenerative/reparative features on biopsy. The 3 adenocarcinomas diagnosed s benign on cytology showed an occasional malignant cell with thickened nuclear borders and prominent central nucleoli. Conclusions: With careful attention to the cytomorphology, coupled with good clinical and endoscopic correlation, crush cytology of the large intestine is a reliable diagnostic tool. It categorizes lesions as malignant and benign with a high sensitivity, positive predictive value, and negative predictive value. Adenomas and reparative/regenerative changes seen in inflammatory bowel disease are major pitfalls in the cytology diagnosis of malignancy that may be averted by informing the endoscopic findings and clinical history. Cytology diagnosis saves time and gives proper feedback to the gastroenterologist.

Original languageEnglish
JournalActa Cytologica
DOIs
Publication statusAccepted/In press - 04-04-2018

Fingerprint

Large Intestine
Cell Biology
Adenoma
Ulcerative Colitis
Inflammatory Bowel Diseases
Colonic Neoplasms
Ulcer
Neoplasms
Histology
Adenocarcinoma
Retrospective Studies
Biopsy
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Histology

Cite this

GV, Chaithra ; Saha, Debarshi ; Yadav, Richa ; Adiga, Deepa S. ; Lobo, Flore D. ; Ghosh, Apurv ; Kini, Jyoti. / The Role of Crush Cytology in the Diagnosis of Large-Intestine Lesions with Correlation on Histopathology. In: Acta Cytologica. 2018.
@article{977dd82a50c0452789d4788b2bd46306,
title = "The Role of Crush Cytology in the Diagnosis of Large-Intestine Lesions with Correlation on Histopathology",
abstract = "Objective: To study the efficacy of colonoscopic crush cytology as a convenient and near-accurate method to evaluate colonic neoplasms. Study Design: Retrospective and cross-sectional. The original cytologic diagnoses were correlated with a histology report on 100 cases sent to the cytology laboratory over 2 years. Results: Of the 100 cases, 25 were nonmalignant. Of the 75 malignant lesions, 72 could be identified as positive for malignancy on cytology. The false-positives consisted of 6 adenomas and 1 case of ulcerative colitis. Thus, sensitivity and specificity of cytology are 96 and 63.2{\%}, respectively. Of the 6 adenomas diagnosed as malignant, 4 showed high-grade dysplasia, and the other 2 showed superficial ulceration with low-grade dysplasia on histopathology. The ulcerative colitis case showed widespread ulcers and regenerative/reparative features on biopsy. The 3 adenocarcinomas diagnosed s benign on cytology showed an occasional malignant cell with thickened nuclear borders and prominent central nucleoli. Conclusions: With careful attention to the cytomorphology, coupled with good clinical and endoscopic correlation, crush cytology of the large intestine is a reliable diagnostic tool. It categorizes lesions as malignant and benign with a high sensitivity, positive predictive value, and negative predictive value. Adenomas and reparative/regenerative changes seen in inflammatory bowel disease are major pitfalls in the cytology diagnosis of malignancy that may be averted by informing the endoscopic findings and clinical history. Cytology diagnosis saves time and gives proper feedback to the gastroenterologist.",
author = "Chaithra GV and Debarshi Saha and Richa Yadav and Adiga, {Deepa S.} and Lobo, {Flore D.} and Apurv Ghosh and Jyoti Kini",
year = "2018",
month = "4",
day = "4",
doi = "10.1159/000487628",
language = "English",
journal = "Acta Cytologica",
issn = "0001-5547",
publisher = "Science Printers and Publishers Inc.",

}

The Role of Crush Cytology in the Diagnosis of Large-Intestine Lesions with Correlation on Histopathology. / GV, Chaithra; Saha, Debarshi; Yadav, Richa; Adiga, Deepa S.; Lobo, Flore D.; Ghosh, Apurv; Kini, Jyoti.

In: Acta Cytologica, 04.04.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Role of Crush Cytology in the Diagnosis of Large-Intestine Lesions with Correlation on Histopathology

AU - GV, Chaithra

AU - Saha, Debarshi

AU - Yadav, Richa

AU - Adiga, Deepa S.

AU - Lobo, Flore D.

AU - Ghosh, Apurv

AU - Kini, Jyoti

PY - 2018/4/4

Y1 - 2018/4/4

N2 - Objective: To study the efficacy of colonoscopic crush cytology as a convenient and near-accurate method to evaluate colonic neoplasms. Study Design: Retrospective and cross-sectional. The original cytologic diagnoses were correlated with a histology report on 100 cases sent to the cytology laboratory over 2 years. Results: Of the 100 cases, 25 were nonmalignant. Of the 75 malignant lesions, 72 could be identified as positive for malignancy on cytology. The false-positives consisted of 6 adenomas and 1 case of ulcerative colitis. Thus, sensitivity and specificity of cytology are 96 and 63.2%, respectively. Of the 6 adenomas diagnosed as malignant, 4 showed high-grade dysplasia, and the other 2 showed superficial ulceration with low-grade dysplasia on histopathology. The ulcerative colitis case showed widespread ulcers and regenerative/reparative features on biopsy. The 3 adenocarcinomas diagnosed s benign on cytology showed an occasional malignant cell with thickened nuclear borders and prominent central nucleoli. Conclusions: With careful attention to the cytomorphology, coupled with good clinical and endoscopic correlation, crush cytology of the large intestine is a reliable diagnostic tool. It categorizes lesions as malignant and benign with a high sensitivity, positive predictive value, and negative predictive value. Adenomas and reparative/regenerative changes seen in inflammatory bowel disease are major pitfalls in the cytology diagnosis of malignancy that may be averted by informing the endoscopic findings and clinical history. Cytology diagnosis saves time and gives proper feedback to the gastroenterologist.

AB - Objective: To study the efficacy of colonoscopic crush cytology as a convenient and near-accurate method to evaluate colonic neoplasms. Study Design: Retrospective and cross-sectional. The original cytologic diagnoses were correlated with a histology report on 100 cases sent to the cytology laboratory over 2 years. Results: Of the 100 cases, 25 were nonmalignant. Of the 75 malignant lesions, 72 could be identified as positive for malignancy on cytology. The false-positives consisted of 6 adenomas and 1 case of ulcerative colitis. Thus, sensitivity and specificity of cytology are 96 and 63.2%, respectively. Of the 6 adenomas diagnosed as malignant, 4 showed high-grade dysplasia, and the other 2 showed superficial ulceration with low-grade dysplasia on histopathology. The ulcerative colitis case showed widespread ulcers and regenerative/reparative features on biopsy. The 3 adenocarcinomas diagnosed s benign on cytology showed an occasional malignant cell with thickened nuclear borders and prominent central nucleoli. Conclusions: With careful attention to the cytomorphology, coupled with good clinical and endoscopic correlation, crush cytology of the large intestine is a reliable diagnostic tool. It categorizes lesions as malignant and benign with a high sensitivity, positive predictive value, and negative predictive value. Adenomas and reparative/regenerative changes seen in inflammatory bowel disease are major pitfalls in the cytology diagnosis of malignancy that may be averted by informing the endoscopic findings and clinical history. Cytology diagnosis saves time and gives proper feedback to the gastroenterologist.

UR - http://www.scopus.com/inward/record.url?scp=85045058359&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85045058359&partnerID=8YFLogxK

U2 - 10.1159/000487628

DO - 10.1159/000487628

M3 - Article

AN - SCOPUS:85045058359

JO - Acta Cytologica

JF - Acta Cytologica

SN - 0001-5547

ER -