Diagnostic Efficacy of Intraoperative Cytology in Relation to Histopathology: A Prospective Study from a Tertiary Care Center

Background: Intraoperative cytology (IOC), including squash, scrape, and imprint techniques, serves as a rapid diagnostic tool during surgical procedures. It provides immediate guidance to surgeons, particularly in differentiating benign from malignant lesions. Histopathology remains the gold standard for definitive diagnosis. The present study was undertaken to evaluate the diagnostic efficacy of intraoperative cytology in comparison with histopathological examination.

Methods: This prospective comparative observational study was conducted in the Department of Pathology at a tertiary care center over one year. A total of 50 specimens from various anatomical sites were evaluated using intraoperative cytology techniques (squash, scrape, and imprint) and subsequently correlated with formalin-fixed paraffin-embedded histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated.

Results: Of the 50 cases, 41 (82%) were females and 9 (18%) were males, with the majority belonging to the 41–60 years age group (48%). Malignant lesions constituted 50% of cases. Intraoperative cytology demonstrated 100% concordance for malignant and tubercular lesions and 95.7% concordance for benign lesions. The overall sensitivity and specificity were 96.15% and 95.83%, respectively, with PPV of 96.15%, NPV of 95.83%, and overall diagnostic accuracy of 96%.

Conclusion: Intraoperative cytology is a rapid, cost-effective, and highly accurate diagnostic modality with excellent correlation to histopathology. It plays a crucial role in real-time surgical decision-making and serves as a reliable alternative in settings where frozen section facilities are unavailable