Objective: Intra-operative cytological diagnosis of the CNS lesions helps the neurosurgeon to decide about the extent of resection particularly in eloquent areas. The squash or crush preparation of the available tiny tumor tissue at the start of the resection is a time saving and lead to better decision on further plan of surgery.
Material and methods - We have prospectively studied the accuracy of this technique at our institute. During the period of last two years we have operated 118 CNS mass lesions including cranial and spinal. All cases were subjected to squash diagnosis and later compared with paraffin sections.
Results - Out of total 118, cranial lesions were 105 and spinal were 13. Males outnumbered in frequency (77 cases, 65.2%) while the females comprised 41 cases (34.7%). Most (59.2%) of the patients were from 20 to 50 years of age. The cerebral hemisphere including all lobes had the largest number of cases (49 cases, 41.5%). Among them glial tumors form the major group (34 cases, 28.8%). Meningiomas were the next main group (18 cases, 15.3%) followed by Schwanommas and metastatic tumors having nine cases (7.7%) each. The cytological or squash diagnosis was possible in all except 11 cases (9.3%), in which a definite diagnosis could not be provided due to fibrous tissue, necrosis, and hemorrhage or poor preservation of cytological features.
Conclusion - Thus, our early experience concluded that Intra-operative SQUASH smear cytology is a fairly rapid and reliable method of intra operative diagnosis for a wide spectrum of central nervous system lesions.