Prospects for utilization and usefulness of postmortem cytology.
Cytologic evaluation of nongynecologic tissues is a widely accepted diagnostic modality commonly used in the clinical evaluation of living patients. Fine needle aspiration (FNA) of superficial masses and touch preparations of surgical specimens often yield diagnostic results. The adjunctive role of these two techniques during postmortem examination has not been adequately addressed. A prospective study was carried out on a series of 13 patients undergoing postmortem examination. FNA was performed in a standard manner to obtain tissue fragments from superficial masses in three cases. Visceral lesions grossly suspicious for cancer were scraped and smeared onto glass slides to create a "touch prep" in 10 cases. Cytologic evaluation of alcohol-fixed, hematoxylin and eosin (H&E)-stained slides was performed in each case. Cytologic diagnoses were subsequently correlated with histologic sections. In the majority of cases, cytologic material was diagnostic. Touch prep slides, in combination with gross findings, were diagnostic of primary and metastatic carcinoma in visceral lesions. FNA of superficial masses accurately assessed local recurrences of carcinoma and nodal metastases. Both methods yielded diagnoses within minutes, in contrast to the time required to process routine histologic sections. Cytologic evaluation of tissues obtained at autopsy provides accurate, inexpensive, and rapid diagnostic information. The touch prep is an inexpensive adjunct to histologic sections in documenting the presence of carcinoma or the extent of metastatic disease found at autopsy, and its further application can strengthen the standard applied in clinicopathologic diagnosis.