title: Cytopathology including fine-needle aspiration in sub-Saharan Africa: a Cameroon experience.
abstract: BACKGROUND
  Surgical pathology is unavailable in most of sub-Saharan Africa because of equipment costs and lack of expertise. Cytopathology is an inexpensive and reliable alternative.
  
  
  OBJECTIVE
  To explore the utility of cytopathology in a rural hospital setting in Africa.
  
  
  METHODS
  A cytopathologist and a pathology resident from Calgary, Alberta, Canada, went to Cameroon to provide a cytopathology service at the Banso Baptist Hospital. Both performed the fine-needle aspiration procedures. Direct smears were fixed in alcohol and stained with hematoxylin-eosin. Surgical specimens subsequently obtained from the patients were processed and reported at Calgary Laboratory Services, Canada. The histopathologic diagnoses were the gold standard for determining the accuracy of the cytologic diagnoses.
  
  
  RESULTS
  Fifty-nine patients were examined during a 5-week period, 33 females (56%) and 26 males (44%). Sixteen (27%) were known to be HIV positive. Forty-four fine-needle aspiration procedures were performed for 43 patients (73%). The cost of each procedure was approximately US $10. Head and neck and breast were the sites most frequently sampled for aspirates. Cervical smears from 5 patients were also assessed, as were 8 fluid specimens and 2 touch preparations of prostatic core biopsies. The most frequent diagnoses for malignancy were carcinoma and lymphoma. Tuberculous lymphadenitis was diagnosed in 6 patients, 4 of whom were HIV positive. Surgical specimens were received from 18 patients (30%). Cytohistologic and clinicopathologic correlation revealed 1 false-positive (1.6%) and 1 false-negative (1.6%) diagnosis.
  
  
  CONCLUSIONS
  Cytopathology is a reliable alternative for tissue diagnosis in low-resource settings.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Alberta, Canada.
authors.forename: Kelly
authors.initials: K
authors.lastname: Guggisberg
authors.forename: Chukwudi
authors.initials: C
authors.lastname: Okorie
authors.forename: Moosa
authors.initials: M
authors.lastname: Khalil
mesh_terms: D044963:Biopsy, Fine-Needle / Q000191:economics / Q000592:standards; D002163:Cameroon; D003581:Cytodiagnosis / Q000191:economics / Q000379:methods* / Q000592:standards; D003906:Developing Countries; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis*; D010865:Pilot Projects; D011204:Poverty Areas; D012424:Rural Population