Refining the Preoperative Diagnosis of Jaw Aspirate

The intra-osseous lesions of oral and maxillofacial region are mostly cystic pathologies or solid tumors which undergo cystic changes. They are diagnostically challenging to clinician due to overlapping clinical and radiographic presentations. As a preliminary diagnostic tool, fine needle aspiration cytology is indicated for these lesions. Identifying the epithelial cells is mandatory in cystic aspirates to arrive at the preoperative diagnosis and treatment plan.

The aim of the study was to detect the epithelial cells from a smear prepared before and after centrifugation of intra bony cystic aspirates.

Aspirates from 15 clinically diagnosed oral cystic lesions were chosen. Totally four smears were prepared, two from non-centrifuged cystic fluid and the another two from centrifuged cystic fluid. They were stained with hematoxyline and eosin (H&E) and papanicolau (PAP) stains, the smears were assessed for the presence of epithelial cells. A comparison has been made to find out which technique and stain is appropriate for identifying epithelial cells and concordance between cytological and histopathological features.

Epithelial cells were identified in smears prepared with or without centrifugation. The smears prepared after centrifugation showed presence of epithelial cells in all 15 cases. The comparison for the presence of epithelial cells using Chi-square test with and without centrifugation in PAP and H&E smears were found to be significant (P ≤ 0.001). The concordance between cytological and histopathological diagnosis was 60%.

The smear prepared after centrifugation of cystic fluid stained with PAP stain was more representative.