Scrape cytology of the ovaries: potential role in intraoperative consultation of ovarian lesions.

Intraoperative diagnosis of ovarian lesions can be achieved by gross examination with the help of frozen sections and/or cytologic examination. Various cytologic techniques, including imprint, fine-needle aspiration, and scrape, may be used. In this study, we evaluated the application of scrape cytology in the diagnosis of ovarian lesions occurring during a 16-mo period at one institution. The cytologic diagnosis was primarily based on findings in air-dried, Diff-Quik-stained smears in correlation with clinical and intraoperative findings. In total, 131 histologically proven ovarian lesions, including 13 nonneoplastic lesions, 47 benign tumors, 17 epithelial tumors of low malignant potential (LMP), and 54 malignant tumors (35 primary, 1 leukemia, and 18 metastases), were cytologically examined. The accuracy of scrape cytology was 95% in the benign, 47% in the LMP, and 98% in the malignant group. In the LMP group, the false-negative rate was 12%, while the deferred rate and false-positive rate were 24% and 18%, respectively. There was no misdiagnosis between the benign and malignant categories. The histologic subtypes were correctly predicted in 78% of cases. There were limitations of scrape cytology in the diagnosis of LMP and mucinous tumors, which require histologic architectural evaluation and adequate histologic sampling. Scrape cytology is a simple, rapid, and inexpensive adjunctive technique that should be used in intraoperative consultation for ovarian lesions. Copyright 2003 Wiley-Liss, Inc.