Intraoperative liquid-based cytology of rinsed tissue fragments from head and neck lesions

Intraoperative diagnosis is an essential tool for the rapid diagnostic assessment of clinically critical head and neck lesions. Thus, we assumed that a combination of frozen section histological and cytological diagnoses may be preferable. Here, we investigated a relatively new method called liquid-based cytology of rinsed tissue fragments (LBC-RTF) and compared this method with intraoperative histological diagnosis.

We used 68 tissue biopsies (9 brains, 8 lymph nodes, 22 salivary glands, and 29 thyroid samples). Samples submitted for intraoperative consultation were divided into two-halves: one was used to prepare frozen sections, and the other was prepared for LBC-RTF by washing with PreservCyt. We then compared the final diagnosis obtained from permanent sections with the intraoperative histological diagnosis based on frozen sections and examination of LBC-RTF preparations.

The accuracy of LBC-RTF was higher than that of intraoperative histological diagnosis alone, based on frozen sections of every organ (LBC-RTF: 91.2% vs intraoperative histological diagnosis: 80.9%). With LBC-RTF, artifacts that are commonly observed in frozen sections were not present. In addition, even with challenging cases from which it is impossible to prepare frozen sections, intraoperative diagnosis was possible using the LBC-RTF technique.

Both histological and cytological intraoperative diagnoses were possible during a surgery if the LBC-RTF technique was used. Moreover, our findings suggest that LBC-RTF improved the diagnostic accuracy of traditional intraoperative diagnosis.