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Impression Cytology in a Series of Clinically Diagnosed Ocular Surface Melanocytic Lesions
Mozhgan Rezaei Kanavi1, Seyed Bagher Hosseini2, Roshanak Aliakbar-Navahi3
1Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Impression cytology (IC) accurately diagnosed most ocular surface melanocytic lesions, correlating well with histopathology. This method aids in managing these conditions, though it doesn't replace biopsy.
Area of Science:
- Ophthalmology
- Cytopathology
- Dermatology
Background:
- Ocular surface melanocytic lesions require accurate diagnosis for effective management.
- Distinguishing between benign and malignant lesions is crucial.
Purpose of the Study:
- To evaluate the diagnostic utility of impression cytology (IC) for ocular surface melanocytic lesions.
- To assess the correlation between IC, clinical diagnosis, and histopathology.
Main Methods:
- Ten patients with suspected ocular surface melanocytic lesions underwent IC.
- Periodic acid Schiff-Papanicolaou staining was used.
- Excisional biopsy and histopathological analysis were performed when necessary.
Main Results:
- IC results showed high agreement with clinical diagnoses (kappa=0.83).
- IC findings correlated well with histopathology (kappa=0.74).
- IC correctly identified benign nevi, primary acquired melanosis with atypia/melanoma, and conjunctival intraepithelial neoplasia.
Conclusions:
- Impression cytology effectively diagnoses the nature of ocular surface melanocytic lesions.
- IC is a valuable adjunct to histopathology in managing these lesions.
Purpose:
To report impression cytology (IC) results of clinically diagnosed ocular surface melanocytic lesions.
Methods:
Ten patients with a clinical diagnosis of an ocular surface melanocytic lesion underwent IC using cellulose acetate strips and Periodic acid Schiff-Papanicolaou staining. Excisional biopsy of lesions was performed in case of observing atypical cells on IC or at the patient's request, and excised specimens were subjected to histopathological analysis. Agreement between clinical diagnoses and IC results and between IC results and histopathology were evaluated.
Results:
Clinical diagnoses were nevi in 6, primary acquired melanosis (PAM) with atypia/melanoma in 2, and atypical nevus versus pigmented conjunctival intraepithelial neoplasia (CIN) in 2 cases. IC results were suggestive of a benign nevus in 7, PAM with atypia/melanoma in 2 and CIN versus an atypical epithelioid type melanocytic lesion in 1 case. IC results were consistent with the clinical diagnoses in 9 cases (Cohen's kappa index of 0.83) and excluded CIN in 1. Histopathology in 6 cases disclosed benign melanonevus in 3, malignant melanoma in the context of PAM with atypia in 2, and CIN in 1 case. Histologic results were well correlated with the IC features (Cohen's kappa index of 0.74).
Conclusion:
By demonstrating typical cytomorphological features of ocular superficial layers IC diagnosed the true nature of melanocytic ocular surface lesions in the majority of cases. Although IC does not substitute histopathology, given the high correlation between IC results and histopathology, it can be of great assistance in diagnosis and management of ocular surface melanocytic lesions.
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