Study of assessing diagnostic efficacy of squash smear technique and frozen section by comparing with histopathology in CNS lesions, with special reference to IHC

Authors : Pakam Dinusha, Vallapureddy Thejaswini, V. Ananta Kiran Kumar, A. Janakiram Reddy, Sama Snehaja Reddy

DOI : 10.18231/j.pjms.2023.038

Volume : 13

Issue : 1

Year : 2023

Page No : 188-197

Introduction: Central nervous system (CNS) squash cytology (CSC) has established itself as a technically simple, rapid, inexpensive, fairly accurate, and dependable intraoperative diagnostic tool. It helps neurosurgeons immensely when management is dependent on it.
Aims : To asses the efficacy of squash cytology in the intraoperative diagnosis of CNS lesions by comparing with histopathological diagnosis.
Materilals and Methods: The present study is a prospective study done for one and a half year includes 43 patients who presented to the department of neurosurgery with complaints of a headache, backache, epilepsy and radiologically diagnosed to have a space occupying lesion. Only the cases where either squash cytology or frozen section was performed were included in the study.
Results : In the present study, it is observed as Out of 43 cases, squash cytology is performed in 42 cases in which histopathological diagnosis is correlated in 36 cases with a diagnostic accuracy of 85.7%. The diagnostic accuracy of squash cytology in common CNS tumors gliomas and meningiomas was 92.8% and 100% respectively. Out of the 43 cases, the frozen section is performed in 42 cases of which histopathological diagnosis is correlated in 37 cases with a diagnostic accuracy of 87%. The diagnostic accuracy of frozen section in common CNS tumors gliomas and meningiomas was 85.7% and 100% respectively. The sensitivity and specificity of frozen section in the identification of tumor was 94.7% and 100%. The positive predictive value and negative predictive value of the frozen section in the identification of the neoplastic lesion was 100% and 66.6% respectively.
Conclusion: Squash cytology and frozen section are preliminary diagnostic methods, which should always be followed by a definitive histopathological diagnosis.

Keywords : Squash cytology, Histopathological diagnosis, Frozen section


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