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Category: Volume 06 Issue 12 December 2018
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Title: Utility of Squash Cytology in the intraoperative diagnosis of Central Nervous System lesions

Authors: Dr Saroj Meshram, Dr Sanjay Parate, Dr Shilpa Tathe, Dr Archana Randale, Dr Milind Bhatkule

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.44

Abstract

Introduction: Various Methods are used for intraoperative diagnosis of central nervous system leision.Squash cytology is one such method which is simple, rapid and accurate. This Study aims to evaluate the utility and accuracy of Squash Cytology in the intraoperative diagnosis of the central nervous system lesions and discuss its diagnostic pitfalls.

Materials and Methods: This Prospective study was conducted between Jan 2015 to dec2017.Rapid intraoperative diagnosis was given in 260 patients by squash cytology. Cytological diagnosis was later compared with Histopathological diagnosis.

Results: Majority of lesions were neoplastic accounting for 96.9% of cases whereas non-neoplastic lesions constituted 3.07% .Overall diagnostic accuracy rate was 95% on comparing with histopathology assuming it as a gold standard.

Conclusion: Squash Cytology is simple, rapid, reliable and effective method for diagnosing neoplastic as well as nonneoplastic lesions of the central nervous system thus helping Neurosurgeon to modify the operative procedure if necessary.

Keywords: Squash Cytology(SC), Intraoperative diagnosis, Central Nervous System lesions (CNS)

References

  1. Eisenhardt L, Cushing H. Diagnosis of Intracranial tumours by Supravital technique. Am J Pathol. 6: 541- 52, 1930
  2. Goel D, Sundaram C, Paul TR, Uppin SG, Prayaga AK, Panigrahi MK, et al. Intraoperative cytology (squash smear) in neurosurgical practice – Pitfalls in diagnosis experience based on 3057 samples from a  single institution. Cytopathology.18:300–8, 2007
  3. Roessler K, Dietrich W, Kitz K. High diagnostic accuracy of cytologic smears of central nervous system A 15-year experience based on 4,172 patients. Acta Cytol.46:667–74,2002
  4. Regragui A, Amarti Riffi A, Maher M, El Khamlichi A, Saidi A. Accuracy of intraoperative diagnosis in central nervous system tumors: Report of 1315 cases. Neurochirurgie.  49(2-3 Pt 1):67–72,2003 intraoperative diagnosis of central nervous system tumors. J Cytol.  27:81–5,2010
  5. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 114:97–109, 2007
  6. Mitra S, Kumar M, Sharma V, Mukhopadhyay D. Squash preparation: A reliable diagnostic tool in the intraoperative diagnosis of central nervous system.Acta Neuropathol.114:97-109, 2007
  7. Iqbal M, Shah A, Wani MA, Kirmani A, Ramzan A. Cytopathology of the central nervous system. Part I. Utility of crush smears cytology in intraoperative diagnosis of central nervous system lesions. Acta   50:608–16, 2007
  8. Savargaonkar P, Farmer PM. Utility of intra-operative consultations for the diagnosis of central nervous system lesions. Ann Clin Lab Sci Spring. 31:133-9, 2001
  9. Sidaway MK, Jannotta FS. Intraoperative cytologic diagnosis of central nervous system. Am J Clin Pathol . 108:556-66, 1997
  10. Shukla K, Parikh B, Shukla J, Trivedi P, Shah B. Accuracy of cytopathological diagnosis of central nervous system tumours in crush preparation. Indian J Pathol Microbiol. 49:483-86, 2006
  11. Cahill EM, Hidvegi DF. Crush preparations of lesions of the central nervous system. A useful adjuvant to the frozen section. Acta Cytol .29:279-85,1985
  12. Torres LFB, Collaco LM. Smear technique for the intraoperative examination of nervous system lesions. Acta Cytol .37:34-40,1993
  13. Powell SZ. Intraoperative consultation, cytologic preparations and frozen section in the central nervous system. Arch Pathol Lab Med 129:1635-52, 2005
  14. Firlik KS, Martinez AJ, Lunsford LD. Use of cytological preparations for the intraoperative diagnosis of stereotactically obtained brain biopsies: A 19- year experience and survey of neuropathologists. J Neurosurg. 91:454-8, 1999
  15. Folkerth RD. Smears and frozen sections in the intraoperative diagnosis of central nervous system lesions. Neurosurg Clin N Am.5:1-18, 1994
  16. Silverman JF, Timmons RL, Leonard JR, 3rd, Hardy IM, Harris LS, O'Brien K, et al. Cytologic results of fine-needle aspiration biopsies of the central nervous system. Cancer. 58:1117–21,1986
  17. Jaiswal S, Vij M, Jaiswal AK, Behari S. Intraoperative Squash Cytology of Central nervous system lesions: A single centre study of 326 cases. Diagn Cytopathol 40:104-12, 2012

Corresponding Author

Dr Sanjay Parate

Department of Pathology Government Medical College and Super Speciality Hospital Near Hanuman Nagar, Nagpur – 440009 Maharashtra India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Tel No: 9822734640