CYTOPATHOLOGICAL PATTERN OF CNS LESIONS IN A TERTIARY CARE HOSPITAL

Abstract

Background: Squash cytology performed intra-operatively is considered as a necessary diagnostic tool. It holds an essential role, especially in the diagnosis of central nervous system tumours. This study was done to determine the role of squash cytology as an independent diagnostic test in our hospital setting in the absence of a frozen section facility.

Materials and Methods: Total number of patients who were included in the study was 62. These patients had presented with different intracranial lesions. Patients had undergone various radio-imaging and routine blood investigations. Post necessary investigations, these patients were operated upon in Neurosurgical department of Government medical college, Srinagar. First squash cytology diagnosis was performed intra-operatively, and then this was correlated with histological diagnosis as gold standard.

Results:  Patients age group included in this study was 5–76 years. Meningioma was the most common benign tumour observed   and astrocytoma was most common malignant lesion diagnosed in our patients. Diagnostic accuracy of intra-operative squash cytology irrespective of lesion & site was 86.33%. We were able to inform about the diagnosis to neurosurgeon in 15 minutes in all cases and within 12 minutes in >85% cases.

Conclusion: Squash smear cytology is reliable and rapid standalone diagnostic method and it can assist for intra-operative decision-making diagnosis of intracranial lesions in resource-limited settings where frozen section facility is not available.

Keywords: central nervous system Intra-operative diagnosis, Squash cytology