title: Preoperative washing cytology in the diagnosis of maxillary sinus lesions.
abstract: OBJECTIVE
  To assess the preoperative value of washing cytology in maxillary sinus lesions with suspected malignancy.
  
  
  METHODS
  Over a 4-year period, 96 p tients with clinical or radiologic suspicion of a malignant maxillary sinus tumor either confined to the maxillary complex or extending to the nasal cavity underwent preoperative cytologic evaluation by sinus puncture and local washing or nasal washing. Subsequently all patients underwent endoscopic sinus surgery (ESS) and partial or total maxillectomy. For controls, 10 patients with rhinosinusitis, who according to standard symptoms and radiologic scores, were candidates for ESS, washing cytology and subsequent random mucosal biopsy were used.
  
  
  RESULTS
  There were 47 malignant, 42 benign and 7 borderline cases. Benign lesions included inflammatory conditions (17), squamous proliferations (6), soft tissue lesions (9) and odontogenic lesions (10). Borderline lesions included hemangiopericytoma (4) and ameloblastoma (3). Malignant lesions included squamous cell carcinoma (8), sinonasal adenocarcinoma (2), salivary gland tumors (4), soft tissue tumors (18), malignant melanoma (8) and hematolymphoid neoplasms (7). The overall sensitivity, specificity, positive predictive value and negative predictive value of preoperative washing cytology were 88.6%, 88.2%, 86.6%, 90%, respectively. Diagnostic agreement between cytology and follow-up biopsy was seen mostly in benign inflammatory and odontogenic lesions and in squamous cell carcinoma and salivary gland malignancies.
  
  
  CONCLUSIONS
  Preoperative sinus washing cytology is a noninvasive and rapid method of diagnosis, with a definite impact on patient surgical planning. Clusters of sloughed epithelial cells, so called Creola bodies, may be a diagnostic pitfall in benign lesions.
authors.affiliation: Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz School of Medicine, Shiraz, Iran. y@daneshbod.com
authors.forename: Yahya
authors.initials: Y
authors.lastname: Daneshbod
authors.forename: Bijan
authors.initials: B
authors.lastname: Khademi
authors.forename: Babak
authors.initials: B
authors.lastname: Moemeni
authors.forename: Iran
authors.initials: I
authors.lastname: Seif
authors.forename: Khosrow
authors.initials: K
authors.lastname: Daneshbod
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003581:Cytodiagnosis / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000473:pathology; D011300:Preoperative Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult