title: Cytology of the vulva: feasibility and preliminary results of a new brush.
abstract: OBJECTIVE
  Taking a biopsy is a standard procedure to make the correct diagnosis in patients with suspicious premalignant vulvar lesions. The use of a less invasive diagnostic tool as triage instrument to determine whether biopsy is necessary may improve patient comfort especially in patients with chronic vulvar disorders that may warrant consecutive biopsies. This study was conducted to investigate whether vulvar brush cytology is feasible and may be used to detect (pre)malignant vulvar lesions.
  
  
  METHODS
  A pilot study was performed with patients having clinically normal vulvar skin, lichen sclerosus (LS), usual or differentiated vulvar intraepithelial neoplasia or squamous cell carcinoma. A total of 65 smears were taken with the use of a vulvar brush and biopsies were performed for histopathological analysis.
  
  
  RESULTS
  Out of 65 smears, 17 (26%) were discarded because of poor cellularity. A total of 28 of 29 (97%) smears with a histological proven (pre)malignancy had a smear classified as 'suspicious' or 'uncertain'. Cytology classified 11 smears as 'non-suspicious', of which 10 (91%) were indeed normal skin or LS. The accuracy, based on the presence of a lesion, for (pre)malignant lesions with the use of the brush showed a sensitivity of 97% and a negative predictive value of 88%.
  
  
  CONCLUSIONS
  Vulvar brush cytology is feasible and may be a first step in the development of a triage instrument to determine whether subsequent biopsy of a clinically (pre)malignant lesion is necessary.
authors: Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen 9101, The Netherlands. l.vandeneinden@obgyn.umcn.nl
authors: L C G
authors: LC
authors: van den Einden
authors: J M M
authors: JM
authors: Grefte
authors: I A M
authors: IA
authors: van der Avoort
authors: J E M
authors: JE
authors: Vedder
authors: L C L T
authors: LC
authors: van Kempen
authors: L F A G
authors: LF
authors: Massuger
authors: J A
authors: JA
authors: de Hullu
mesh_terms: D005240:Feasibility Studies; D005260:Female; D006801:Humans; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000473:pathology; D014626:Vaginal Smears / Q000295:instrumentation*; D014846:Vulvar Neoplasms / Q000175:diagnosis* / Q000473:pathology