Rapid cytodiagnosis of endoscopic biopsy specimens in gastrooesophageal malignancy

Abstract

Squash cytology has been used extensively in examining central nervous system lesions. Recently this technique has been employed in examining endoscopic biopsy specimens. This study was conducted to assess the diagnostic value of squash cytology of biopsy samples from gastrooesophageal malignancies, and to evaluate the efficacy of Leishman's stain for rapid cytologic evaluation of squash preparations. One hundred and fifty five patients with oesophageal or gastric malignancy were subjected to endoscopic biopsy. The first biopsy specimen from each patient was crushed between two glass slides for cytologic evaluation. The smears were stained with Leishman's and Papanicolaou's stains. The results of squash cytology were then compared with histopathology. A positive diagnosis of malignancy was obtained by histology in 146 cases (94.2%) and by squash cytology in 141 cases (90.9%), by both Leishman's and Papanicolaou's staining. In 12 cases (7%) cytology revealed 'suspicious cells'. Histology plus squash cytology together gave a positive yield in 153 cases (98.7%). In 7 cases (4.5%) although squash cytology was positive for malignancy, hispathologic study failed to reveal malignancy. Squash cytology is a useful adjunct to conventional endoscopic biopsy for gastrooesophageal malignancy. This technique which does not require any additional effort or equipment may add to the diagnostic yield besides expediting the workup. Leishman's staining, which is simple, quick and inexpensive is as efficacious as Papanicolaou's method for squash cytology.