title: Utility of squash smear cytology in intraoperative diagnosis of central nervous system tumors.
abstract: BACKGROUND
  Central nervous system (CNS) squash cytology (CSC) has established itself as a technically simple, rapid, inexpensive, fairly accurate, and dependable intraoperative diagnostic tool. It helps neurosurgeons immensely when management is dependent on it.
  
  
  OBJECTIVE
  This study aimed at finding out the utility of CSC as an intraoperative diagnostic tool from a neurosurgeon's perspective.
  
  
  METHODS
  Fifty prospectively registered patients with clinical diagnosis of CNS tumors were enrolled in the study. All the patients were subjected to magnetic resonance imaging (MRI). Intraoperative CSC was performed and smears were stained with Leishman and rapid Hematoxylin and Eosin (H and E) stain. The diagnosis of CSC was compared with MRI diagnosis and histopathological diagnosis. The CNS tumors were categorized based on clinical and therapeutic implications. Diagnostic accuracy, sensitivity, specificity, and positive and negative predictive value of MRI and CSC were calculated by using appropriate formulae.
  
  
  CONCLUSIONS
  The age range of the CNS tumors included in the study was 2 to 68 years. There was a slight female preponderance. Sensitivity, specificity, positive predictive value, and negative predictive value of preoperative MRI were 90.47%, 82.76%, 79.17%, and 92.31% respectively. These values of utility parameters for CSC were 100% for each of the clinical and therapeutic implications. It helped neurosurgeons in optimizing surgical procedure in 12 cases of meningioma. It influenced surgical management in 1 case of infratentorial pilocytic astrocytoma, and helped in the diagnosis and management of 9 unexpected tumors missed on MRI.
authors.affiliation: Department of Pathology and Neurosurgery, B J Government Medical College, Pune, Maharashtra, India.
authors.forename: Savita S
authors.initials: SS
authors.lastname: Patil
authors.affiliation: Department of Pathology and Neurosurgery, B J Government Medical College, Pune, Maharashtra, India.
authors.forename: Jyoti K
authors.initials: JK
authors.lastname: Kudrimoti
authors.affiliation: Department of Pathology and Neurosurgery, B J Government Medical College, Pune, Maharashtra, India.
authors.forename: Rachana D
authors.initials: RD
authors.lastname: Agarwal
authors.affiliation: Department of Pathology and Neurosurgery, B J Government Medical College, Pune, Maharashtra, India.
authors.forename: Meenal V
authors.initials: MV
authors.lastname: Jadhav
authors.affiliation: Department of Pathology and Neurosurgery, B J Government Medical College, Pune, Maharashtra, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Chuge
keywords: CNS squash cytology; CNS tumors; intraoperative diagnosis