Aj. Molyneux et al., THE VALUE OF LYMPH-NODE IMPRINT CYTODIAGNOSIS - AN ASSESSMENT OF INTEROBSERVER AGREEMENT AND DIAGNOSTIC-ACCURACY, Cytopathology, 8(4), 1997, pp. 256-264
The aim of this study was to assess the reliability of cytodiagnosis o
f lymph node imprints without fixed tissue sections. One hundred rando
mly selected archival cases were used in the study. These air-dried Ma
y-Grunwald-Giemsa imprint slides were assessed independently and blind
by three pathologists, Cases were assigned to one of four diagnostic
categories: reactive changes, non-Hodgkin's lymphoma (NHL), Hodgkin's
disease (HD) and secondary malignancy. Each broad diagnosis was compar
ed with the 'correct' reviewed histological diagnosis to calculate int
erobserver agreement and diagnostic accuracy. The overall kappa score
(+0.59) was indicative of moderate agreement. The mean pathologist dia
gnostic accuracy was 78%, with complete agreement with the histologica
l diagnosis in 61% of cases. The main diagnostic difficulties were in
the distinction between reactive changes and NHL and distinguishing NH
L from HD. Further diagnostic classification, e.g. typing of lymphomas
and subclassification of Hodgkin's disease, was not found to be relia
ble using the imprints alone. With these limitations in mind, patholog
ists should be able to use lymph node imprints for cytodiagnosis in se
lected cases. The study also emphasized the utility of imprints as a c
orollary to the histology and as a tool for cytology training and cont
inuing education.