Diagnostic accuracy of central nervous system tumors by squash cytology

ABSTRACT

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.