Role of squash smear in intraoperative consultation of central nervous system tumors

Introduction: Intraoperative squash smear cytology is an important diagnostic tool; it guides the neurosurgeon during surgical resection and lesion targeting. It also helps the surgeon to monitor and modify the approach at surgery. Inherent soft nature of the central nervous system (CNS) lesions yields good quality material on squash smears because of scant connective tissue. In this study, we have assessed the diagnostic accuracy of squash smear by comparing with histodiagnosis. Materials and Methods: This was a prospective study; we received 75 cases for squash cytology during the study. Complete clinical and radiological findings were recorded. The smears were stained by rapid hematoxylin and eosin method. The cytomorphological features were studied on squash preparation and cytodiagnosis was informed to neurosurgeon peroperatively, and it was compared with tissue sections. Results: Peak incidence of brain tumors was observed in the 31–40 years age group and male to female ratio was 1:1.1. Astrocytomas formed the largest category of tumors. Sixty-eight cases showed complete concordance with final histodiagnosis, with a diagnostic accuracy of 90.67%. Conclusion: Squash smear cytology proved to be a simple, inexpensive, rapid technique for intraoperative consultation of CNS tumors and also aids the neurosurgeon for further proper management.