Accuracy and utility of intraoperative squash smear cytology in neurosurgical practice

Background: Intraoperative squash smear cytology (ISSC) is a rapid and reliable diagnostic tool that provides guidance to the neurosurgeon for precise targeting of the lesion and its surgical resection. It also helps the surgeon to modify the approach at surgery at times based on the preliminary impression of the lesion on cytology. Objectives: The present study was undertaken to assess the utility of ISSC for cytomorphological diagnosis in a resource-limited setting. The accuracy of the method was assessed by correlating cytological diagnosis with histopathological diagnosis. Materials and Methods: A total of 106 cases of central nervous system (CNS) tumors were examined by squash smear technique for cytological diagnosis which were then compared with histopathological diagnosis provided on paraffin-embedded sections. Results: Cytohistological correlation was available in all the 106 cases included in the study. Of these 106 cases, 96 were concordant with the final histopathological diagnosis, while 10 were discordant. Thus, complete correlation with final histopathological diagnosis was observed in 90.56% of cases. Conclusion: Intraoperative squash smear cytology proved to be a simple, rapid, and inexpensive technique for intraoperative consultation of CNS tumors in the absence of frozen section facility.

Diagnostic accuracy of central nervous system tumors by squash cytology

Background: Squash cytology has shown to be of great value in intraoperative consultations of central nervous system lesions. Intraoperative smear cytology provide a rapid and reliable diagnosis and guidance to the neurosurgeon during surgical resection and lesion targeting. Squash smear technique saves time and amount of tissue needed. Aim: To study the validity of rapid intraoperative diagnosis of central nervous system lesions by examining the squash cytologic smears of central nervous system lesions. Materials and methods: A total of 111 cases of intracranial space occupying lesions were studied. This squash smears were prepared from the intraoperative biopsy samples and remaining tissue fixed in formalin and sent for histopathological examination. Squash smears were stained with toluidine blue and rapid haematoxylin and eosin. Squash smear cytological diagnosis was correlated with histopathological findings. Results: Out of 111 cases, in 11 (9.9%) cases showing discordance was observed between squash smear diagnosis and histological diagnosis. In 100 (90.1%) cases, squash smear diagnosis was in accordance with the final histologic diagnosis. Thus the value of squash smear technique in rapid intraoperative diagnosis of neurosurgical biopsies was corroborated by above study and the accuracy of this study match with other studies done in the past on squash smear technique. Conclusion: Squash smear cytology should be used regularly for rapid intraoperative diagnosis of central nervous system lesions, as squash smear technique is economical, reliable, feasible intraoperative rapid diagnostic method and has a place in determining the immediate management.

Role of squash smear technique in intraoperative diagnosis of CNS tunmors.

Background: Neurosurgical practice frequently requires intraoperative consultation to optimize surgical procedure. Frozen section and Squash smear cytology can offer the same. As brain tissue is friable & predisposed to show ice crystal artefacts, frozen section is often difficult to interpret. Squash smear examination provides good cytological details to offer diagnosis in most cases except where anatomical correlation is needed. Present study was undertaken to evaluate the efficacy of Squash smear in absence of frozen section facility. Aims & Objective: To evaluate the value of Squash smear cytology for rapid intraoperative diagnosis in CNS lesions and its correlation with final histomorphological diagnosis. Material and Methods: Total 35 case of CNS tumours were examined by squash smear technique for cytomorphological analysis followed by histomorphological correlation on paraffin section. Results: Complete correlation with histomorphological findings was observed in 82.35% of cases. Complete correlation was observed more with glial neoplasm. Conclusion: Squash smear preparation proved to be a simple, inexpensive and rapid technique for intraoperative consultation of CNS tumours and can be effectively utilized as a diagnostic tool for intraoperative diagnosis in absence of frozen section facility.