The role of cytology in the diagnosis of benign and malignant anal lesions.
Squamous cell carcinoma is a rather infrequent neoplasm of the gastrointestinal tract. Nevertheless its frequency is increasing lately especially in high risk groups of the population infected from HIV or HPV viruses. Squamous cell carcinoma is a slowly and locally growing neoplasm which metastasizes in advanced stages. Its diagnosis must be accomplished by the least traumatic examinations possible. In our study we reviewed our five years experience that included 116 cases. In 89 of them cytological material from ulcerated positions of the anal region was examined. In the rest 27 cytological material was obtained by fine needle aspiration of subcutaneous or submucosal anal lesions. All 116 case reports were retrospectively evaluated. Cytological evaluation revealed 29 cases of normal anal epithelium, 13 granulomas, 12 cases of HPV infection, 28 anal squamous intraepithelial lesions (ASIL), 17 post radiation injuri-es of the anal mucosa and 17 carcinomas. The neoplasms were further subclassified in 12 well differentiated squamous cell carcinomas, 4 cloacogenic carcinomas and 1 leiomyosarcoma. Histological examination followed the initial cytological diagnosis in 75 cases. The correlation between cytological and histological reports did not reveal any false negative or any false positive result. The agreement between histological and cytological evaluation was absolute. Cytological examination is proved to be an easily accessible and totally reliable, low cost diagnostic method, not requiring any kind of anesthesia. It is well accepted by the patients and of paramount clinical utility for the initial diagnostic assessment, the long-term follow up after treatment of anal cancer patients. It is also valuable for the differential diagnosis among benign, premalignant and malignant anal lesions.
Karaitianos
I G
IG
Departement of Surgical Oncology, St Savvas Anticancer Hospital , Athens, Greece.
Archondakis
S K
SK
Korkolis
D
D
Koundouris
C
C
Xenitidis
M
M
Daskalopoulou
D
D
Tsigris
C
C
D000328:Adult; D001004:Anus Diseases / Q000175:diagnosis*; D001005:Anus Neoplasms / Q000175:diagnosis*; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003581:Cytodiagnosis; D006801:Humans; D008875:Middle Aged