Tumor irrigation fluid enhances diagnostic efficacy  in endoscopic biopsies of intracranial space-occupying lesions.
OBJECTIVE
Intraventricular neuroendoscopic CNS biopsiesare small, fragmented, and tissue is frequently inadequate for diagnosis. We have attempted to increase cellular yield using tumor irrigation fluid (TIF) and a cyto-histological approach for diagnosis of intracranial tumors, cysts, and infections.


METHODS
A retrospective group of 147 cases, where only endoscopic biopsies were obtained, was compared with a prospective group of 31 cases where along with the endoscopic biopsies, tumor irrigation fluid (TIF) was collected. Tumor cyst fluid was obtained from cystic tumors (n=6). Small tumor fragments in the TIF were utilized to make squash smears (n=31). Clotted fragments were processed for sections in (n=3). Centrifuged deposit smears were prepared from tumor irrigation fluid and tumor cyst fluid.


RESULTS
Conclusive pathological diagnosis in endoscopic biopsies could be arrived at in 77.4% (24/31) prospective cases and 80.3% (118/147) in retrospective cases. Collection of TIF with a cyto-histological diagnostic approach gave a significantly higher rate of conclusive pathological diagnosis in 93.5% (29/31) cases in the prospective group.


CONCLUSIONS
Additional tissue from TIF preserves the original biopsy, provides more material for diagnosis and gives a better morphological picture in smears. Hence diagnosis of endoscopic CNS biopsies can be rendered in more cases and with greater degree of confidence.
Department of Pathology, CSM Medical University, Lucknow, UP, India. drnuzhathusain@hotmail.com
Nuzhat
N
Husain
Malti
M
Kumari
Mazhar
M
Husain
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods* / Q000592:standards; D001927:Brain Diseases / Q000473:pathology*; D001932:Brain Neoplasms / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003560:Cysts / Q000473:pathology*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007223:Infant; D007239:Infections / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D007507:Therapeutic Irrigation / Q000592:standards; D055815:Young Adult