A comparative study of squash smear cytology diagnosis and radiological diagnosis with histopathology in central nervous system lesions

BN Kumarguru; G Santhipriya; S Kranthi Kumar; R Ramesh Kumar; AS Ramaswamy; P Janakiraman

doi:10.4103/JOC.JOC_13_20

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ORIGINAL ARTICLE

Year : 2022 | Volume : 39 | Issue : 1 | Page : 1-8

A comparative study of squash smear cytology diagnosis and radiological diagnosis with histopathology in central nervous system lesions

BN Kumarguru¹, G Santhipriya², S Kranthi Kumar³, R Ramesh Kumar⁴, AS Ramaswamy¹, P Janakiraman⁵
¹ Department of Pathology, PES Institute of Medical Sciences and Research, Kuppam, Chittoor, Andhra Pradesh, India
² Department of Pathology, East Point College of Medical Sciences and Research Centre, Kuppam, Chittoor, Andhra Pradesh, India
³ Department of Neurosurgery, PES Institute of Medical Sciences and Research, Kuppam, Chittoor, Andhra Pradesh, India
⁴ Department of Radiodiagnosis, PES Institute of Medical Sciences and Research, Kuppam, Chittoor, Andhra Pradesh, India
⁵ Department of Community Medicine, PES Institute of Medical Sciences and Research, Kuppam, Chittoor, Andhra Pradesh, India

Correspondence Address:
Dr. B N Kumarguru
'Sri'nivasa, No: 204, 9^th Cross, BEML Layout, Basaveshwaranagara, Bengaluru - 560079, Karnataka
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/JOC.JOC_13_20

Background: Space occupying lesions (SOLs) of central nervous system (CNS) constitutes important cause of neurological morbidity and mortality. Squash cytology is technically a simple and rapid intraoperative diagnostic tool. Radiology is supportive of histopathological diagnosis. Objectives: To enumerate the histopathological patterns of various central nervous system (CNS) lesions, to correlate cytopathological diagnosis with histopathological diagnosis, and to correlate radiological diagnosis with histopathological diagnosis. Materials and Methods: It was a retrospective study of CNS lesion cases from January 2015 to August 2018. Cytological-histopathological concordance and radiological-histopathological concordance were calculated. Chi-square test was the statistical tool used for statistical analysis. Results: Histopathological diagnosis of 50 cases included neoplastic lesions (42 cases [84%]) and non-neoplastic lesions (8 cases [16%]). Correct diagnosis was achieved by squash cytology in 36 cases (72%) and radiological diagnosis in 25 cases (50%) by complete concordance. However, diagnostic accuracy of squash and radiology improved considerably by 90% and 76%, respectively, after applying partial concordance criteria. For the detection of neoplastic lesions, squash cytology had 98% and radiology had 80% diagnostic efficacy. Conclusion: Preoperative radiological investigation and intraoperative squash smear cytology are complementary to each other. A multidisciplinary approach is necessary for the management of patients.

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