Abstract
Background: A new approach like squash smears and frozen section to diagnose CNS neoplasm intra-operatively can help the neuro-pathologist in an intra-operative setting to diagnose and provide sufficient preliminary information to optimize the surgical management of the patient, especially in stereotactic surgery. Majority of the CNS lesions have better preserved cytological detail in squash smear, however tissue architecture is preserved in frozen section. Hence along with squash smear, frozen section is used to emphasize its advantages for intra-operative diagnosis. Thus a study is undertaken in a tertiary care hospital as to compare the efficacy of squash cytology and frozen section with histopathology diagnosis, considering it as the gold standard.
Material & Method: All the neurosurgical specimen with suspected CNS neoplasm received in the Department of pathology of IMS & SUM Hospital for intra-operative consultation was studied prospectively for a period of 3years(august 2014-july 2017). Intra-operative squash cytology and simultaneous frozen section were done and the diagnosis were compared with the final paraffin-embedded section.
Result and Observation: A total of 18.89% of case were found discordant in squash smears and 21.12% of cases were discordant for frozen section considering the histopathology as gold standard .Technical errors like thick smearing artefact, frozen artefact, limited tissue sample, crushed specimen cautery induced &crushing artefacts contributed to misdiagnosis.
Conclusion: Though the squash smears showed a reasonably higher percentage of diagnostic accuracy over frozen section in intra-operative diagnosis of CNS neoplasm, both the procedures should be used complementarily and not as substitution.
Study type and design: Hospital based cross-sectional study & is an observational study.
Keywords: central nervous system lesions, comparative efficay, squash cytology, frozen section, histopathology.
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Corresponding Author
Dr Debahuti Mohapatra
Professor and Head, Department of Pathology, IMS and SUM Hospital, Bhubaneswar751003, Odisha, India
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Cell: 09439831760
DOI: https://dx.doi.org/10.18535/jmscr/v7i1.124
