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OBJECTIVE(S) : To establish the validity and reliability of imprint cytology in intraoperative diagnosis of ovarian tumors and to compare it with histopathology. METHOD(S) : Multiple imprint smears were taken from the resected tumor masses during surgery in 67 patients. After staining, the findings were noted and compared with subsequent histopatho...
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... cytology has been widely used in intraoperative diagnosis of various tumors 2,3 . But its use in intraoperative diagnosis of ovarian neoplasms has not been widely recognized. There are only a few reports describing its accuracy and validity. We have done intraoperative cytology in 67 cases and followed it up histologically. Out of them 61.19% were benign tumors and 38.81% malignant.This is comparable to the findings of Ramachandran et al 4 who reported 68.9% of benign tumors. In our study the most common type of epithelial tumor was serous tumor (37/67; 55.22%). Pravakar and Maingi 5 also found it to be the most common epithelial ovarian tumor but their incidence was 32.7%. Serous cystadenoma comprised 20 cases (20/67; 29.85%) of all ovarian tumors. Similar incidence is quoted by Saxena et al 6 ,Verma and Bhatia 7 and Tyagi et al 8 . Age range was between 23 and 55 years. All of them were unilateral, cystic and contained clear fluid. Imprint cytology was 90.98% accurate. Malignant serous tumors accounted for 17.94% of all ovarian tumours (Figure 1). Ramachandran et al 4 found a lower incidence of 7.09%. Since benign tumors, in most instances, are asymptomatic, seldom cause abdominal swelling, and acute pain occurs only due to torsion of the mass, patients tend to neglect them and come to the hospital only after development of features of malignancy like ascitis, menstrual disturbances, pain etc. In our study, the serous tumors of borderline malignant potential were diagnosed either as benign (two cases) or malignant (three cases). In the absence of complex branching, nuclear pleomorphism and hyperchromasia, the overall morphology of cells closely resembles that of a benign serous tumor.And also, it is extremely difficult to separate epithelial tumors of low malignant potential from well differentiated carcinomas 9,10 . Mucinous tumors formed the second most common epithelial tumour of the ovary (13/67; 19.40%). Pravakar and Maingi 5 reported them to be 25%. They are the largest tumors among the ovarian tumors. The largest tumor seen in our study was of 13 kg which was a mucinous cystadenoma. (Figure 2). Imprint cytology has shown 100% diagnostic accuracy in case of mucinous cystadenoma and mucinous cystadenocarcinoma. All cases of benign endometrioid tumors were correctly diagnosed by imprint cytology. In the three endometrioid carcinomas one was misinterpreted as mucinous adenocarcinoma giving a 66.6% correlation with histopathology. Among germ cell tumors, the most common in our study was benign cystic teratoma and imprint cytology showed 100 % diagnostic accuracy (Figure 3). Most of them showed benign squamous epithelial cells, cyst macrophages, and foreign body giant cells produced in response to keratin released by the squamous cells. Glandular epithelial cells, fat and skeletal muscle were occasionally found. All cases of dysgerminoma were accuratetely diagnosed by imprint cytology. Only one case was a mixed tumor viz., germ cell tumor with sex cord stromal tumor; the second component was missed by cytology.The age ranged from 17 to 23 years and all were solid and unilateral with smooth or bosselated external surface. Although yolk sac tumor is the second most common malignant germ cell tumor we had only one case which was in a 16 year old girl (Figure 3). The tumor showed large areas of hemorrhage and necrosis. It was diagnosed by presence of loosely clustered glandular epithelial cells with prominent cytoplasmic vacuolation and occasional eosinophilic hyaline globules. There was only one case of granulosa cell tumor which was misdiagnosed as adenocarcinoma.The monomorphic round cells ...
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Background:
In the intraoperative consultation of ovarian tumors, the histological diagnosis of frozen sections (FS) of large tumors is frequently difficult because of the limited number of tumor samples. The application of imprint cytology (IC), in which samples are obtained from wide areas of the tumors, is useful for intraoperative consultation...
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... Similar studies by Naseer et al, Kar et al also showed very low malignant masses. 9,10 Non neoplastic ovarian cysts were the most common ovarian mass observed in our study. Studies also suggests that non-neoplastic cysts were common in adolescents. ...
Background: Ovarian torsion is 5th most common emergency in gynecology. Benign functional ovarian cysts and benign teratomas are most common among ovarian torsion. Aims and objectives were to study the outcome and HPE of all adolescent girls presenting with acute pain abdomen at BGS GIMS, Bangalore. Methods: A study was conducted at BGS GIMS from 2020 to 2022 of all children and adolescents presenting with acute pain abdomen. Study included data consisting of age, complaints, investigations, intervention and HPE was collected and analysed. Results: There were 21 cases between 12- and 21-years age group who presented with acute pain abdomen in the study period. Majority of them were of 16-19 years age group. Out of 21 cases, 100% of them presented with acute pain abdomen. Operative procedures included 15 (71%) exploratory laparotomy and 6 (29%) operative laparoscopies. Ovarian torsion was seen in 11 cases of which 2 cases had bilateral ovarian torsion and 9 cases had unilateral torsion. Ovarian cystectomy was done in 7 patients, unilateral oophorectomy in 3 patients and unilateral salpingo-oophorectomy in 6 patients. Histopathology reports showed 5 cases of serous cystadenoma, 1 case of teratoma and others were mostly simple cyst or corpus luteal cysts. Conclusions: Acute pain abdomen in adoloscents should be diagnosed early to prevent from risk of ovarian torsions. Operative procedures should aim at fertility preservation.
... Rapid intraoperative diagnosis of the nature of the ovarian tumour in young woman avoids unnecessary removal of the contra lateral ovary and helps in preservation of fertility. It can also be used for stagingof malignancy,for postoperative followup and for recurrence [11]. Materialsobtained fromimprintcanbe used for flow-cytometry and cytogenetic studies. ...
... As per the mucinous tumours were concerned, 4 out of the 5 cases of mucinous cystadenocarcinoma were wrongly diagnosed as mucinous cystadenoma by and 1 out of 2 cases of mucinous cystadenoma was wrongly diagnosed as mucinous cystadenocarcinoma by imprint cytology. All cases of the serous papillary cystadenoma (11) were correctly diagnosed by imprint cytology. Only one borderline case of serous tumour was wrongly diagnosed as benign tumours 2 cases of yolk sac tumours were wrongly identified by imprint cytology as an a plastic carcinoma. ...
... The largest tumour seen in our study was mucinous cystadenocarcinoma. Similarly Studies by Kar Tushar et al. [11]. also showed mucinous cystadenocarcinoma in their study as the largest tumour. ...
Background: The ovaries are female reproductive organs and at the same time, the site of origin of some of the most complex as well as lethal neoplasms. Aims: The present study was conducted to assess whether imprint cytology can help in rapid diagnosis of ovarian neoplasm and thus facilitate individualized treatment. Materials and Methods: This prospective study was carried out in the Department of Pathology in a tertiary care hospital in collaboration with Department of Gynaecology after taking Institutional ethical committee approval. Fifty patients, attending Gynaecology and Obstetrics OPD & indoor and diagnosed clinically & radiologically (USG) as cases of ovarian tumour was selected. After taking valid consent from the patients, a detailed history was taken and clinical examination was done preoperatively. Imprint smears were made intraoperatively from fresh samples and stained with M.G.G. stain for air dried smears and Papanicolaou stain for alcohol fixed smears. Results: Out of total 50 cases, 32(64%) was epithelial tumours and 18(36%) non-epithelial tumour cases. Age group varied from 5 to 62 years. Overall sensitivity in our study to diagnose benign and malignant ovarian tumours by imprint cytology is 94% and the specificity is 74% with positive and negative predictive value of 63% and 96% respectively. Diagnostic accuracy was 78% with high statistical significance (p<0.001). Conclusion: By taking samples from a variety of representative tumour areas, the accuracy of this method can be improved. Imprint cytology's accuracy is on par with that of frozen section histology. Therefore, extensive use of imprint cytology should be made in the management of patients with ovarian neoplasia.
... In the present study , maximum number of cases were in 4th to 6th decade of life. Our study is in concordance with Kar et al [13] and Phukan et al [10] , where it was 40-59 years age. In another study by Rangaliya et al [14] benign neoplasms were most commonly seen in 3rd to 5th decade, whereas malignant tumors were seen in 5th decade. ...
... Among the major histological classes, the most common ovarian tumor in our study is surface epithelial tumor (76.9%). Similar results were found by studies by Rangaliya et al [14] and Kar et al [13] at 75.43% and 79% respectively. However a higher incidence of surface epithelial tumor (90%) was recorded by Guppy et al [17]. ...
... Germ cell tumors in our study comprised of 19.6% of all ovarian tumors. This nding is similar to ndings of studies by Rangaliya et al [14] (19.30%) and Kar et al [13] (16%). ...
Introduction : Ovarian tumor accounts for 30% of female genital tract cancers and comprises of large variety of neoplastic entities. Mortality rate has due to ovarian tumor has gradually increased. The present study was undertaken to study the frequency of various histomorphological spectrum, histological subtypes and age distribution pattern of ovarian tumors. Methods: Retrospective study was carried during period of 1st January 2015 to 31st st December 2019, 455 cases of ovarian neoplastic lesions were taken from the records of the department. Classication was done according to WHO classication. Results: Of the 455 cases, 332 cases (73%) were benign, 16 cases (3.5%) cases were borderline and 107 cases (23.5%) cases were malignant. Among the histological subtypes surface epithelial tumors are common comprised of 76.9% followed by germ cell tumors (19.6%). Serous cystadenoma (42.8%) was the most common benign tumor followed by mature cystic teratoma (16.5%). Among the malignant tumors, the most common was Serous cyst adenocarcinoma (11.9%) Tumors were seen over age range of 11-81 years. Maximum number of cases were in the 4th to 6th decade. Benign tumors were primarily seen in Younger age group , whereas malignant tumors were common in elderly age group. Conclusions: In our study we analysed all the spectrum of ovarian tumors diagnosed on the basis of histomorphology. Surface epithelial tumors were the commonest ovarian tumor. Maximum numbers of ovarian tumors were in the age range 40-59years and malignant tumors were common in age >40 years
... But Kar K et al. recorded low incidence of sex cord-stromal tumours 3.84% and Garg R et al. noted not even a single case in their study. 16,21 In our study metastatic tumours account for 3.4% and 1.1% were grouped under unclassified. Our findings show less incidence of metastatic tumours than Chandanwale et al., Kar et al., Gilani et al. who has shown the incidence of 6%,7.69% and 6.6% respectively. ...
... However, Thakkar and Shah [9] found only 25.6% of their patients in the age group 20-39 years and 53.5% in the age group 40 -59 years. Kar et al. [16] reported 46.25% of patients in the age group 40-59 years. [14] 7% 58% 30% 5% Ramchandra et al. (1972) [15] 7.9% 53% 30% 9.1% Present study 8 [7] and Prakash et al. [8] while Amod et al. [17] show 76.92% non-neoplastic lesions, 17.48 % Benign neoplastic, 1.39% borderline neoplastic and 4.19% malignant neoplastic lesion of ovary which was not comparable with that of our present study. ...
... All the cystic lesions were benign. Our findings 21 were similar to the findings of Kar Two cases of serous cystadenocarcinoma showed metastasis to rare sites like cervix and appendix. Another case of serous cystadenocarcinoma showed coexistence with stromal sarcoma of the uterus. ...
Background: Ovarian tumors are one of the most common tumors, which occur in female genital tract. Despite the newer techniques in imaging and molecular biology, the diagnosis of ovarian tumors primarily depends on histopathological examination. Ovarian tumors manifests a wide spectrum of clinical, morphological and histological features. The aim of the study was to find the incidence of surface epithelial ovarian tumors in a tertiary referral centre. Materials and methods: A retrospective data of 3 years were collected for surface epithelial ovarian tumors submitted to the pathology department of the tertiary care hospital and analysed. The correlation of these surface epithelial ovarian tumors was done with age, clinical presentation and histomorphological patterns. Non-neoplastic lesions like simple ovarian cysts, tubo-ovarian mass and polycystic ovaries were excluded. Results: A total number of 56 cases were studied. Out of which 44 cases were benign and 12 cases were malignant. Maximum cases were observed between 21 to 30 years. Mass per abdomen was the most common presentation(36%) followed by mass and pain in abdomen(27%).Serous cystadenoma formed maximum 28 cases(50%) followed by Mucinous cystadenoma(16 cases) 28 % , Serous cysadenocarcinoma formed 5cases (9%), followed by Mucinous cystadenocarcinoma 3 cases(5%) & 2 cases each(4%) of clear cell carcinoma and endometrioid carcinoma were noted. The most common histopathological type of benign and malignant tumor was serous cystadenoma (50.2%) and serous cystadenocarcinoma(9%) respectively. Conclusion: In the study majority (78.6%) of the surface epithelial ovarian tumors were benign. Malignancy was seen in (21.4)% of the cases. Surface epithelial tumours present a great challenge to the gynecologic oncologist because non-neoplastic ovarian lesions can form a pelvic mass and potentially mimic a neoplasm. Correct histopathological diagnosis of surface epithelial ovarian tumors is of prime importance in view of their behavioral predictability and clinical correlation for proper management of the patient.
... This was because of the absence of endometrial cells or stroma or hemosiderin-laden macrophages on cytology smears. Similar findings were found in a study done by Khunamornpong et al. [19] , Nagaia et al. [20] , Abdelghany et al. [21] , and Tushar et al. [22] . In the present study, 6 cases of mucinous borderline tumours and 1 case of the serous borderline tumour were reported on cytology as benign mucinous cystadenomas and benign serous cystadenoma respectively. ...
... 10 In this study, malignant morphology comprised of highest percentage among all neoplastic tumor but in other study report from this country as well as western part of the globe, benign tumor found to be the highest numbers. 4,6,11,12 The high incidence of malignant tumor in this study could have been due to referral bias since this study was conducted in a regional cancer centre. In other hand, further complete research is needed to elucidate region specific factors behind the high incidence of ovarian malignancy in this area. ...
... malignant tumor, serous cystadenocarcinoma consisted of maximum. This was in agreement with the study done by Sharadha et al, Gupta et al, Kar et al, and Mondal et al.4,6,11,12 But in other studies granulosa cell tumors were recorded as most predominant malignant type by Swamy et al, and endometroid carcinomas was found to be the most common ovarian malignancies by Yasmin et al.14,15 ...
Background: Ovarian cancer is the leading cause of cancer related death amongst women in India. Identification of histological types helps to predict tumor behaviour and further appropriate management. Aims and objectives is to study the histopathological parameters of ovarian tumor.Methods: This retrospective study was done on patients who presented ovarian mass and subsequently underwent surgery in a Regional Cancer Centre, Odisha, over a period of three years from January 2016 to December 2018. All datas such as age, site, gross findings and histological tumor types were retrieved from pathology and analyzed using MS Excel worksheet.Results: A total 612 cases of ovarian tumor were included for study. Non-neoplastic to neoplastic tumor ratio was 1:7.74. Surface epithelial tumors comprised the majority of tumors, accounting for 452 cases (83.39%). Malignant lesions were predominant in this series 416 cases (76%). Majority of borderline tumors were of mucinous subtype 20 (76.92%). The Mean±SD ages of all benign comprising, borderline and malignant tumors were 47.4±11.9, 44.9±14.3 and 46.9±13, respectively. On the basis of two tired grading system, high grade malignant serous tumors were maximum, 226 (74.34%). Ovarian surface involvement, omental invasion, uterine invasion, LVSI, capsular invasion and pelvic lymph node involvement was observed in 146 (35.26%), 106 (25.6%), 12 (2.89%), 70 (16.9%), 6 (1.44%) and 12 (2.89%) respectively. According to the FIGO staging system, among primary malignant tumor, 58% patients were presented in late stage (III and IV).Conclusions: The high incidence of malignant ovarian tumor with late presentation was observed in our study. So, further study is warranted to elucidate the major factors in our population.
... In the present study 570 cases (95.48%) were unilateral and 27cases (4.52%) were bilateral. This is similar to studies conducted by Prabhakaran et al (12) , Misra etal (13) , Couto F et al (14) , Kar etal (15) Ovarian tumors may occur at any age including infancy and childhood. In the present study, ovarian tumors were common in the age group 40-49yrs. ...
... were benign, 1(2.86%) was borderline and 7(20%) were malignant; similar findings were seen in studies conducted by Pilli et al. [8] , Yagambal et al. [9] , Nirani et al. [10] , Dimpal et al. [11] In present study maximum number of cases 23(65.71%) were seen between the age group of 40-59 years, similar finding was seen in studies conducted by Phukan A et al. [6] and Kar et al. [12] ; other studies conducted by Pilli et al. [8] and Ramachandran et al. [13] showed maximum cases in the age group of 20-39 years. A total of 17(48.58%) ...
