Intra-operative squash cytology in diagnosing intracranial tumours- a useful method in resource-limited setting with lack of frozen section facility
Journal Title: Medpulse International Journal of Pathology - Year 2017, Vol 4, Issue 3
Abstract
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 and 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. Aim: To evaluate the value of Squash smear cytology for rapid intraoperative diagnosis in CNS tumours. Materials and Methods: The study has been conducted for a period of two years from August 2014-July 2016. Total 36 patients with various intracranial lesions were enrolled in the study. Patients underwent various radio-imaging techniques and routine blood investigations. Later on, intra-operative squash cytology was performed and rapid diagnosis was made. Results: Of 36 cases, 88.9% (32 cases) were malignant and 11.1% (4 cases) were benign on squash cytology. Amongst malignant, gliomas were the most common constituiting to 15cases (41.7%). Other tumours which were studied are pilocyticastrocytoma, oligodendroglioma, schwannoma, lymphoma, medulloblastoma and ependymoma. Overall diagnostic Accuracy of squash was 95.25%. We were able to inform about the diagnosis to neurosurgeon in 15 minutes in all cases and within 12 minutes in >85% cases. Conclusion: Squash smear cytology is reliable, cost-effective, reproducible and rapid standalone diagnostic method and it can assist for intra-operative decision-making diagnosis of intracranial lesions in resource-limited settings where frozen section facility is not available.
Authors and Affiliations
Prachi 1, Sreelekha B V
Keywords
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