Accuracy and utility of intraoperative squash smear cytology in neurosurgical practice

Abstract

Background: Intraoperative squash smear cytology (ISSC) is a rapid and reliable diagnostic tool that provides guidance to the neurosurgeon for precise targeting of the lesion and its surgical resection. It also helps the surgeon to modify the approach at surgery at times based on the preliminary impression of the lesion on cytology. Objectives: The present study was undertaken to assess the utility of ISSC for cytomorphological diagnosis in a resource-limited setting. The accuracy of the method was assessed by correlating cytological diagnosis with histopathological diagnosis. Materials and Methods: A total of 106 cases of central nervous system (CNS) tumors were examined by squash smear technique for cytological diagnosis which were then compared with histopathological diagnosis provided on paraffin-embedded sections. Results: Cytohistological correlation was available in all the 106 cases included in the study. Of these 106 cases, 96 were concordant with the final histopathological diagnosis, while 10 were discordant. Thus, complete correlation with final histopathological diagnosis was observed in 90.56% of cases. Conclusion: Intraoperative squash smear cytology proved to be a simple, rapid, and inexpensive technique for intraoperative consultation of CNS tumors in the absence of frozen section facility.