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.
Husain
Nuzhat
N
Department of Pathology, CSM Medical University, Lucknow, UP, India. drnuzhathusain@hotmail.com
Kumari
Malti
M
Husain
Mazhar
M
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