Intraoperative squash cytology of spinal cord lesions with histopathological correlation

Abstract

Introduction: Intraoperative squash cytology of central nervous system (CNS) tumors is an extremely important modality. Diagnosing brain lesions by squash cytology has been well documented but less studies are available about its utility in spinal tumors . Objectives: Assess role of squash cytology in spinal tumors and correlate with histopathology Materials and Methods: A total of 20 cases of spinal tumor s were taken over a period of 15 months. Squash smears prepared were immediately put in 95% ethyl alcohol for 2 minutes for wet fixation and stained with rapid H and E stain and air dried smears with toluidine blue. The smears were typed according to the cytomorphological criteria and the cytodiagnoses was compared with the histopathological diagnoses and a correlation was established. Results: In our study, histopathology was taken as the gold standard. In a total of 20 cases ,the majority lesions in our series were Metastatic lesions followed by Schwannoma.The other tumors were Neuroblastoma ,ependymoma. Results were compared , there was 1 discordant lesion , and Diagnostic accuracy was 95 % .Highest diagnostic accuracy was documented in Schwannoma, Ependymoma and Neuroblastoma, PNET . Conclusion: Squash preparation is a rapid and easy method with fairly high diagnostic accuracy. If interpreted with clinical picture and radio-imaging findings, will help to reach an accurate and rapid intraoperative diagnosis in spinal lesions. Keywords: Metastatic lesions, Schwannoma, Ependymoma and Neuroblastoma.