Contribution of exfoliative cytology to the diagnosis of laryngeal lesions

OBJECTIVE: To estimate the diagnostic accuracy and reliability of exfoliati ve laryngeal cytology. STUDY DESIGN: Over three years (1996-1999) cytologic smears were obtained f rom clinically suspicious laryngeal lesions during laryngoscopy in a total of 31 selected patients (28 males and 3 females with an age range from 28-9 0 years). The cytologic diagnoses were analyzed and correlated with the his tologic and final clinical diagnoses in 17 and 14 cases, respectively. Cyto logic identification of the exact histologic type of the lesion was evaluat ed in 17 patients front whom both cytologic smears and biopsy material were obtained. RESULTS: The overall specificity was 100%, with no false positive diagnoses . The overall sensitivity was 93.3%, with one false negative cytologic diag nosis, in a case of non-Hodgkin's lymphoma. Cytohistologic correlation show ed complete agreement between cytologic and histologic, diagnoses in five o f six benign lesions, in four cases of dysplasia and in sir cases of squamo us cell carcinoma. The overall diagnostic accuracy of cytology was 96.7% CONCLUSION: Exfoliative cytology by the smear technique is a reliable and a ccurate method in clinically suspected laryngeal lesions. Moreover, exfolia tive cytology may be applied as the only alternative diagnostic method, esp ecially in elderly patients with coexistent cardiorespiratory problems, whe n biopsy is not advisable or indicated.