Study of Squash Smear Cytology in Intraoperative Diagnosis of CNS Tumors- A Tertiary Care Centre Experience in Western Odisha

Background: Intraoperative squash smear cytology is an effective method for the prompt diagnosis of neurosurgical specimens. This method is easy, rapid, inexpensive and designed to evaluate the precision of intraoperative squash smear cytology in identifying space-occupying lesions within the Central Nervous System (CNS). Aims and Objectives: To evaluate the value of squash smear cytology for rapid intraoperative diagnosis of CNS tumors. To know the pattern of CNS tumors cytologically. To determine the limitations of squash smears. Methods: Intraoperatively, tumor tissues obtained from the neurosurgeon were subjected to a squash smear examination at the Department of Pathology, VIMSAR, Burla. The tissue samples were gently squashed between glass slides, stained with rapid Hematoxylin and Eosin (H & E) and Diff-Quik stain, and examined under a microscope. The cytological features were documented and correlated with subsequent histopathological diagnoses obtained from formalin-fixed, paraffin-embedded sections. Results: Eighty cases were received from the Department of Neurosurgery, of which 9 were non-neoplastic cases and 71 had neoplastic lesions. Meningioma accounted for the largest group of tumors among the neoplastic lesions, with 35 cases (49.29%). A total of 65 cases (91.54%) showed complete correlation with histopathology, one case (1.40%) showed partial correlation, and 5 (7.04 %) were discordant. Conclusion: Squash smear cytology is a reliable, rapid, and cost-effective method for intraoperative diagnosis of CNS tumors.