title: Diagnostic implications of histological analysis of neurosurgical aspirate in addition to routine resections.
abstract: Many neurosurgical centers use surgical aspirators to remove brain tumor tissue. The resulting aspirate consists of fragmented viable tumor, normal or tumor-infiltrated brain tissue as well as necrotic tissue, depending on the type of tumor. Typically, such fragmented aspirate material is collected but discarded and not included when making the histopathological diagnosis. Whereas the general suitability of surgical aspirate for histological diagnosis and immunohistochemical staining has been reported previously, we have systematically investigated whether the collection and histological examination of surgical aspirate has an impact on diagnosis, in particular on the tumor grading, by providing additional features. Surgical and aspirate specimens from 85 consecutive neurosurgical procedures were collected and routinely processed. Sixty-five of the 85 specimens were intrinsic brain tumors and the remainder consisted of metastatic tumors, meningiomas, schwannomas and lymphomas. Important diagnostic features seen in surgical aspirate were microvascular proliferation (n = 3), more representative necrosis (n = 2), and gemistocytic component (n = 2). In one case, microvasular proliferations were seen in the aspirate only, leading to a change of diagnosis. Collection of surgical aspirate also generates additional archival material which can be microdissected and used for tissue microarrays or for molecular studies.
authors.affiliation: Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. gelareh.zadeh@uhn.on.ca
authors.forename: Gelareh
authors.initials: G
authors.lastname: Zadeh
authors.forename: Fateme
authors.initials: F
authors.lastname: Salehi
authors.forename: Shu
authors.initials: S
authors.lastname: An
authors.forename: Christopher
authors.initials: C
authors.lastname: Uff
authors.forename: Sophie
authors.initials: S
authors.lastname: Camp
authors.forename: Tamas
authors.initials: T
authors.lastname: Revesz
authors.forename: Janice
authors.initials: J
authors.lastname: Holton
authors.forename: Maria
authors.initials: M
authors.lastname: Thom
authors.forename: Andrew W
authors.initials: AW
authors.lastname: McEvoy
authors.forename: Joan
authors.initials: J
authors.lastname: Grieve
authors.forename: Neil
authors.initials: N
authors.lastname: Kitchen
authors.forename: Sebastian
authors.initials: S
authors.lastname: Brandner
mesh_terms: D001707:Biopsy, Needle; D001932:Brain Neoplasms / Q000175:diagnosis*; D004273:DNA, Neoplasm / Q000032:analysis; D006801:Humans; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D004273:DNA, Neoplasm