Cytopathology of the central nervous system. Part I. Utility of crush smear cytology in intraoperative diagnosis of central nervous system lesions.
OBJECTIVE
To evaluate the utility of rapid intraoperative crush smear cytologic diagnosis of central and peripheral nervous system lesions and to determine the accuracy and relevance of the accuracy of the intraoperative cytologic diagnosis when compared to the final paraffin section diagnosis.


METHODS
The crush (squash) smear technique was introduced at Sher-i-Kashmir Institute of Medical Sciences in May 2003. The 8 months of 2003 were used for standardization of the procedure. In 2004, 151 patients with open neurosurgical specimens or stereotactic biopsies were diagnosed intraoperatively by crush smears, and the diagnosis was compared with final diagnosis on paraffin sections of the same tissue samples. No supplementation of frozen sections was used.


RESULTS
Of 151 cases, 144 were diagnosed accurately intraoperatively by crush smear cytology when compared with the respective paraffin section diagnoses. The diagnostic accuracy attained was 95.36%. Each case was diagnosed within 10 minutes after receipt of sample. Neurosurgical procedure (open or stereotaxy) did not affect diagnostic accuracy.


CONCLUSIONS
In the expert hands of a pathologist with good exposure neurosurgical specimens, crush smear cytology is an accura and reliable procedure for the intraoperative diagnosis central nervous system tumors.
Iqbal
Mohamad
M
Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India. mohdiqballone@yahoo.com
Shah
Azra
A
Wani
M Afzal
MA
Kirmani
Altaf
A
Ramzan
Altaf
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods / Q000592:standards; D016543:Central Nervous System Neoplasms / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006652:Histological Techniques / Q000379:methods* / Q000592:standards; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016612:Paraffin Embedding; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results