Utility of Scrape Cytology in The Diagnosis of Neoplastic Lesion

Background: Scrape cytology is a rapid, simple, and cost-effective cytodiagnostic technique used for the preliminary evaluation of surgically resected lesions. It provides good cellular yield from the freshly cut surface of specimens and may help in early differentiation between benign and malignant tumours, particularly in centres where frozen section facilities are limited. The aim is to evaluate the utility of scrape cytology in the diagnosis of surgically resected neoplastic lesions. Material and Methods: This cross-sectional study was conducted in the Department of Pathology, S. V. Medical College, Tirupati, over a period of 6 months after Institutional Ethics Committee approval. A total of 141 surgically resected specimens with clinically suspected neoplasia were included. Scrape smears were prepared from the freshly cut surface of the lesions, stained with rapid haematoxylin and eosin and May-Grünwald-Giemsa stains, and examined microscopically. The scrape cytology diagnosis was compared with the final histopathological diagnosis, which was considered the gold standard. Diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Results: Out of 141 cases, 134 cases were diagnosed on scrape cytology, while 7 cases were undiagnosed due to inadequate or non-representative cytological material. Among the diagnosed cases, 96 were categorized as benign and 38 as malignant on scrape cytology. On histopathological correlation, scrape cytology showed an overall diagnostic accuracy of 86%, sensitivity of 71%, specificity of 93%, positive predictive value of 83%, and negative predictive value of 87%. Discordance was observed in 18 cases, mainly involving thyroid, breast, parotid gland, and testicular lesions. Conclusion: Scrape cytology is a useful, rapid, inexpensive, and reliable adjunctive diagnostic technique for the evaluation of surgically resected neoplastic lesions. It is particularly valuable for early differentiation of benign and malignant tumours in routine pathology practice. However, due to limitations in assessing tissue architecture, invasion, margins, and tumour typing, scrape cytology cannot replace histopathology. Final histopathological examination remains essential for definitive diagnosis.

Keywords: Scrape cytology; neoplastic lesions; histopathology; intraoperative diagnosis; cytodiagnosis; benign; malignant.