IMPRESSION CYTOLOGY (IC) IN CLINICAL PRACTICE

Abstract

Objective: Nasal cytology is the most useful technique in differentiating infectious rhinitis from other types of rhinitis. Various techniques have been described for obtaining nasal cytology specimens, including blowing secretions into wax paper; taking a smear by using cotton wool swabs or brushes; or performing nasal scraping, lavage, biopsy and impression cytology.
We aimed to compare impression cytology findings between allergic, vasomotor and infectious rhinitis patients and the control group as far as eosinophils, neutrophils, basophilic cell, goblet cells and bacteria counts were concerned.
Material and Method: In this study, we used an alternative method, namely Impression Cytology (1C) which is a noninvasive diagnostic procedure allowing the collection of a monolayer of cells from the epithelial or mucous surface. 1C was used in 28 allergic rhinitis, 21 vasomotor rhinitis and 23 infectious rhinitis patients. There were 22 control subjects in this study.
Results: IC was found to show significantly higher gradings of eosinophil counts and goblet cell counts in allergic rhinitis patients as
compared to other groups (p<0.001); whereas neutrophil counts were found to be higher in the infectious rhinitis patients as compared to other groups (p<0.001). In the basophilic cell counts allergic rhinitis and the infectious rhinitis patients were found to present higher gradings as compared to the control group (p<0.05). Bacteria invasion detected by IC was present only in the infectious rhinitis patients with a percentage of
26.1.
Conclusion: Our study has shown that IC is a very valuable and practical technique, offering a valuable alternative test for investigating cytology in all rhinitis and other pathologies causing cytologic changes.
Key Words: Impression cytology, rhinitis,
eosinophil, basophilic cell, neutrophil.

References

1. Meitzer EO, Schatz M, Zeiger RS. Allergic and non-allergic rhinitis. In: Middleton E Jr, Reed CE, Ellis EE (Eds). AllergyO Principles and Practice, 3rd ed. CV Mosby, St Louis, 1988; 1253-1289.
2. Egbert PR, Laube S, Maurice DM. A simple conjunctival biopsy. Am J Ophthalmol. 1977;84:798-801.
3. Thatcher RW, Darougar S, Jones B. Conjunctival impression cytology. Arch Ophthalmol. 1977;95:678-681.
4. C in clinical practice
5. Şapçı T. Gürda! C, Onmuş H, et al. Diagnostic significance of impression cytology in allergic rhinoconjunctivitis. Am J Rhinology 1999;13:31-35.
6. Meltzer EO, Orgel tlA, Jalowayski A. nasal
7. Cytology. In: naclerio RM, Durham SR, Myglnd n (Eds). Rhinitis: Mechanisms and
8. management. Marcel Dekker Inc, new York, 1998:175-202.

9. naclerio RM. Vasomotor rhinitis. In: Gates GA (Ed). Current therapy In otolaryngology head and neck surgery. 6th edition, CV Mosby, St Louis, 1998:505-513.
10. Bryan MF, Bryan WTK. Cytologic diagnosis in allergic disorders. Otolaryngol Clin north Am 1974;7:637-666.
11. Cohen GA, MacFherson GA, Golembesky LIE et al. normal nasal cytology in infancy. Ann Allergy 1985;54:1 12-124.
12. Ohtsuka LI, Okuda M. Important factors in the nasal manifestations of allergy. Arch Otorhinolaryngol 1981 ;233:22 7-235.
13. Hansel FK. Observation on the cytology of the secretions in allergy of the nose and paranasal sinuses. J Allergy 1934;5:357-366.
14. Hansel FK. Cytologic diagnosis in respiratory allergy and infection. Ann Allergy 1966;24:564-569.
15. Mullarkey MF, Hill JS, Webb DR. Allergic and non-allergic rhinitis: their characterization with attention to the meaning of nasal eosinophilia. J Allergy Clin Immunol 1980;65:122-126.
16. Elwany S, Bumsted R. Ultrastructural observations on vasomotor rhinitis. ORL J Otorhinolaryngol Relat Spec 1987;49:199- 205.
17. Malm berg H. Symptoms of chronic and allergic rhinitis and occurrence of nasal secretion granulacytes in university students, school children and infants. Allergy 1979;34:389-394.
18. Meltzer EO, Orgel HA, Bronsky EA et al A dose-ranging study of fluticasone propionate aqueous nasal spray for seasonal allergic rhinitis assessed by smptmos, rhinomanometry and nasal cytology. J Allergy Clin Immunol 1990;86:221-230.
19. Gill FF, Heiburger JB. The role of nasal cytology in the diagnosis of chronic sinusitis. Am J RhinoI 1989;3:13-15.
20. I 7. Lim MC, Taylor RM, naclerio RM. The histology of allergic rhinitis and its comparison to cellular changes in nasal lavage. Am J Respir Crit Care Med 1995;151:136-144.
21. Miller R, Faradise JL, Friday GA et al. The nasal smear for eosinophils. Its value in children with seasonal allergic rhinitis. Am J Dis Child 1982; 136:1009-1011.
22. Felikan Z, Felikan-Flipek M. Cytologic changes in the nasal secretions during the immediate nasal response. J Allergy Clin Immunol ¡988:82:1 103-1 I 12.
23. Fipkorn U, Karlsson C, Enerback L. A brush method to harves cells from the nasal mucosa for microscopic and biochemical analyanalysis. J Immunol Methods 1988; 112:37-42.