Utility Of Squash Cytology In Diagnosing Cns Lesions

BACKGROUND: The different modalities used for intraoperative consultation of CNS lesions are squash smear cytology, frozen sections & fluid cytology. The intraoperative diagnosis of squash cytology enables the surgeon to take decision regarding treatment. Squash technique requires small sample size, needs minimal technical equipment, is less expensive and gives better morphological detail. The present study was taken to assess the diagnostic accuracy of intraoperative squash cytology of CNS lesions. MATERIALAND METHODS: It is a prospective study conducted for one and half year in the department of Pathology. All lesions of brain and spinal tract comprised the study group. The stain used for squash cytology was rapid haematoxylin and eosin. The squash diagnosis was compared with gold standard histopathology. RESULTS: Total 96 cases were studied. Male to female ratio was 1.13:1. The overall concordance rate was 89.13% (including both complete and partial agreement cases). Good correlation was noted in diffuse astrocytoma (100%) and least correlation was noted in anaplastic oligodendroglioma (28.5%). CONCLUSION: Squash cytology is a rapid and simple technique for intraoperative diagnosis with high overall accuracy.

Utility Of Squash Smear Cytology In Intraoperative Diagnosis Of Central Nervous System Lesions

INTRODUCTION- The accurate diagnosis of disease tissue is elementary to the precise diagnosis and proper management of central nervous system lesions. Although histopathology is gold standard, in neurosurgical practice intraoperative cytological diagnosis is now well established and emerge as a dependable standalone diagnostic tool. The rapidity at which sufficient preliminary information for optimal surgery is provided to neurosurgeons, help him take crucial decision regarding patients management. Overall soft nature of CNS lesions ,best suited for smear cytology, which in fact is the major restriction while performing intraoperative Frozen section consultation. So the present study was done to assess the utility of squash cytology in intraoperative diagnosis of CNS lesions. MATERIALAND METHODS-In this prospective study 142 patients with clinical diagnosis of CNS lesions were studied. Patients clinical and radio imaging findings were taken into account while evaluating squash smear preparation. Squash diagnosis was latter correlated with final histopathological diagnosis . RESULTS– Out of 142 cases, cytological diagnosis was offered in 136 cases. In 6 cases no opinion was possible on cytology. Cyto-histological correlation was seen in 127 out of 136 cases, 9 cases remained discordant. Thus overall diagnostic accuracy of squash cytology in intraoperative diagnosis of CNS lesions in our study was 93.38%. CONCLUSION- Intraoperative squash cytology is easy ,rapid, reliable and cost-effective technique for neurosurgical consultation with fairly high accuracy. Knowledge of clinicoradiological details help to further improve the diagnostic accuracy

A 2 year study of meningiomas in correlation with squash cytology and histopathological examination

Background: Meningiomas are common CNS tumors arising from the meningothelial cells and usual sites are intracranial, followed by intra spinal. WHO 2007 has categorised meningiomas into 3 grades. This grading helps in predicting their behaviour and treatment. Aim and objectives: To study the frequency, clinical details, histological typing of meningiomas in comparison with squash cytology (intra operative diagnosis) and Histopathological examination post operatively. Materials and methods: The present study was a prospective study conducted from May 2015 to April 2017 in the Department of Pathology, Gandhi Hospital. We received 50 clinically as well as radiologically diagnosed cases of meningiomas, which were compared with squash cytology and Histopathological examination. Results: In our study, meningiomas constituted 15% of all CNS tumors received from the Neurosurgery Department in a period of 2 years. In the present study, the number of Meningiomas was 50. Females outnumbered males (36 out of 50). Common site was intracranial (45), followed by intra spinal-thoracic (5). The commonest sub type was meningothelial variant of meningioma (12), followed by transitional variant (11). Squash cytology matched with the Histopathological examination in 91.15% cases. Conclusion: Meningiomas are predominantly occur intra cranially with female preponderance, majority were of benign grade I neoplasms. Squash cytology plays a major role in their intra operative diagnosis.

Study of intraoperative squash cytology of intracranial and spinal cord tumors.

Background: The aim was to study the cytomorphology of neoplastic lesions of brain and spinal cord by intraoperative squash cytology, compare it with the histopathological diagnosis on excision biopsy/surgical specimen and establish a correlation. The causes of erroneous diagnoses achieved at squash cytology of intracranial and spinal cord tumors were ascertained. Tumor types having the advantage of diagnostic certainty by squash cytology of intracranial and spinal cord lesions was also determined. Methods: Squash preparations of 70 patients suspected to have neoplasia were made and stained with rapid hematoxylin and eosin stain and rapid Papanicolaou stain. A few squash smears were also dry fixed and stained with Giemsa stain. The smears were typed according to the cytomorphological criteria and the cytodiagnoses was compared with the histopathological diagnoses and a correlation was established. Results: A positive predictive value for intraoperative squash cytology for diagnosis of intracranial and spinal cord tumors was seen to be 100% and a negative predictive value of 97.22% were established by this study. The sensitivity was found to be 97.22% and the specificity was 100%. Thus, the accuracy of the study was 98.57%. Conclusions: Squash smear cytology of the brain and spinal cord tumors performed intraoperatively for diagnostic consultation fulfills all the determinants of an excellent diagnostic modality.

Diagnosis of intraoperative squash cytology in brain tumors / Монголын Анагаах Ухаан

Background: The intraoperative smear cytology (squash preparation) is fairly accurate, simple, reliabletool for rapid intraoperative diagnosis of neurosurgical biopsies [1]. In the early 1930s, Dr Eisenhardtand Cushing introduced intraoperative cytological investigations for rapid examination of neurosurgicalspecimens and guidance of surgical treatment [2]. Besides rapid decision making during neurosurgicalprocedures, it is also to be ensured that minimum injury is caused to the normal brain structuressurrounding the intracranial neoplasm. It has become necessary for pathologists to train themselves inthe interpretation of cytomorphological features of various central nervous system lesion and used inmany neurosurgical units of all over the world [3]. Thus, to begin doing intraoperative squash cytology inour practice is the aim of this study.Aim: To study the diagnostic accuracy of squash cytology in the intraoperative diagnosis of centralnervous system tumorsMaterials and Methods: The material for this study was obtained from 30 cases of nervous systemneoplasms sent for intraoperative consultation from State Third Central Hospital, Shashtin to the thirdsection of National Center for Pathology between 7th of November 2013 to 28th of March 2014. Squashpreparation was performed on all cases and stained with hematoxylin and eosin. The diagnosis given onsquash cytology was then compared with final diagnosis given on paraffin-embedded sections.Results: Of total 30 cases of primary central nervous system tumors, neuroepithelial tumors are thelargest category of tumors (50%). The accuracy of squash cytology was 82.1%.Conclusion: This is the first study in our country where intra-operative squash cytology in brain tumorwas done and diagnostic accuracy was 82.1% as very good category. There were 4 cases had diagnosticdiscrepancy.