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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(05): E735-E740
DOI: 10.1055/a-1388-6479
Original article

Crush cytology: an expeditious diagnostic tool for gastrointestinal tract malignancy

Pankaj Desai
1   Department of Endoscopy & Endosonography, Surat Institute of Digestive Sciences (SIDS), Surat, India
,
Mayank Kabrawala
2   Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, India
,
Chintan Patel
1   Department of Endoscopy & Endosonography, Surat Institute of Digestive Sciences (SIDS), Surat, India
,
Priya Arora
3   Department of Pathology, Surat Institute of Digestive Sciences (SIDS), Surat, India
,
Rajiv Mehta
2   Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, India
,
Subhash Nandwani
2   Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, India
,
Parika Kalra
2   Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, India
,
Ritesh Prajapati
2   Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, India
,
Nisharg Patel
2   Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, India
,
Krishna Parekh
4   Department of Clinical Research, Surat Institute of Digestive Sciences (SIDS), Surat, India
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Abstract

Background and study aims Crush cytology is a simple and rapid method used for diagnosis of central nervous system lesions. We have evaluated the diagnostic accuracy of crush cytology for gastrointestinal tract lesions.

Patients and methods This was a prospective, cross-sectional, single center study, conducted on the patients who had suspected malignant lesions between August 2018 and March 2020. The crush cytologic diagnoses were correlated with histology to determine the diagnostic accuracy.

Results During the period of interest, a total of 451 patients (26.4 % esophagus & GE junction, 16.6 % stomach, 5.9 % ampulla & duodenum, and 50.9 % colorectal) had a suspected malignant lesion on endoscopic examination. Histology confirmed 92.9 % cases as malignant lesions and 7.1 % as nonmalignant. On crush cytology, 84.5 % were positive for malignancy, 8.9 % were negative for malignancy and 6.6 % were reported as suspicious for malignancy. The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of crush cytology were 97.3 %, 90 %, 99.2 %, 72.5 % and 96.9 %, respectively.

Conclusions Crush cytology is a highly sensitive, specific, rapid and cost effective technique to diagnose gastrointestinal malignancies in endoscopically suspected malignant lesions. However, it cannot entirely substitute histopathological examination for definite tumor typing, grading, confirming invasion and in cases in which cytology is suspicious. Crush cytology is an added asset to the histology to maximize diagnostic accuracy and accelerating decision making for the management of lesions.



Publication History

Received: 10 June 2020

Accepted: 30 December 2020

Article published online:
22 April 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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