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Diagnostic Utility of Intraoperative Squash Smear Technique in Neurosurgical Biopsies by Comparing Squash Smear Versus Paraffin Sections

Shanthi Vissa, Professor and Head, Department of Pathology, Narayan Medical College, Nellore, Andhra Pradesh 524003, India. , Shanthi Vissa* , Nandam Mohan Rao** , Grandhi Bhavana*** , Byna Syam Sundara Rao** , Vijaya Lakshmi Muram Reddy*** , Pakam Dinusha****

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Indian Journal of Pathology: Research and Practice 6(3(part-2)):p 772-776, Jul-Sep 2017. | DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.6317.46

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Abstract

Background: Squash smear technique is reliable diagnostic tool which provides neurosurgeons with rapid intraoperative diagnosis and helps them to modify their surgical approach. This study was done to assess the accuracy and diagnostic utility of squash smear technique by comparing with histopathological diagnsosis. Materials and Methods: Our study included 33 patients who underwent operation in neurosurgical department, Narayana Medical College and hospital, Nellore. Squash smear technique was used to provide intraoperative diagnosis and was correlated with histopathological diagnosis. Results: 33 cases were studied, out of which 2 were inflammatory lesions and 31 were neoplastic. Neoplastic lesions included astrocytomas (42.4%), meningiomas (27.3%), oligodendrogliomas (3.03%), ependymoma (3.03%), chordoma (3.03%), schwannoma (9.09%), choroid plexus papilloma (3.03%), and pituitary adenoma (3.03%). Non neoplastic cases were 2 cases of tuberculoma (6.06%). Accuracy rate of squash smear technique was 87.9% in our study. 100% accuracy was found in astrocytomas which were maximum in our study followed by meningiomas. Conclusion: squash cytology provides reliable and rapid diagnosis for neurosurgeons. Accuracy is good in astrocytomas when compared to inflammatory conditions and rare tumors like ependymoma and chordoma. Clinical features and radiological findings should be considered to increase the accuracy of squash cytology.

Keywords: Squash Cytology; Intraoperative Diagnosis. 

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DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.6317.46

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