DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20182304

Intraoperative squash cytology and histopathological correlation of primary temporal lobe lesions: a 6 year study at tertiary care centre of Kashmir, India

Mohd Iqbal Lone, Tazeen Jeelani, Gazanfar Rashid, Nusrat Bashir, Dekyong Angmo

Abstract


Background: Central nervous system (CNS) tumors constitute about 1-2% of all the tumors. They are the 6th most common tumors in adults and 2nd most common among childhood tumors. Gliomas are the most common CNS neoplasms. In addition to gliomas temporal lobe has predilection for some peculiar tumor subtypes having good prognosis, including pleomorphic xanthoastrocytoma (PXA), low grade astrocytic tumors and dysembryoplastic neuroepithelial tumor (DNET) in children.

Methods: Study was conducted in the department of pathology Sher-e-Kashmir institute of medical sciences (SKIMS) Soura, Srinagar Kashmir India. This was six-year study.

Results: Temporal lobe tumors were commonly seen in 3rd to 4th decade of life accounting for 37.9% of the cases followed by 4th to 5th decade (27.5%). The mean age of presentation being 40±10 yrs. Males outnumbered females with a male: female ratio of 1.7:1. Intraoperative squash smears were mostly reported as High grade gliomas (WHO Grade III-IV) accounting to a total of 42 cases (36.2%). On histopathology frequent temporal lobe tumor seen was Glioblastoma multiforme (GBM) 17.4%, followed by pleomorphic xanthoastrocytoma and oligodendroglioma accounting for 14.6% of cases each. On comparing the diagnostic accuracy of intraoperative squash smears to that of Histopathological diagnosis an overall accuracy of 86.2% was observed.

Conclusions: Intra operative squash technique in CNS tumors is universally accepted method. In temporal lobe lesions, on adequate sampling and careful examination, squash cytology has fairly good diagnostic accuracy rate of 86.2% when compared to histopathology.


Keywords


Diagnostic accuracy, GBM, DNET, PXA, Squash smears

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References


Cha S. Update on brain tumor imaging-from anatomy to physiology. AJNR Am J Neuroradiol. 27;2006:475-87.

Dasgupta A, Gupta T, Jalali R. Indian data on central nervous system tumors: a summary of published work. SAJC. 2016;5(3):147-53.

Wen PY, Kesari S, Malignant gliomas in adults. N Engl J Med. 2008;359:492-507.

Thakkar JP, Dolecek TA, Horbinski C, Ostrom QT, Lightner DD, Barnholtz-Sloan JS, et al. Epidemiologic and molecular prognostic review of glioblastoma. Cancer Epidemiology and Prevention Biomarkers. 2014 Oct 1;23(10):1985-96.

Folkerth RD. smears and frozen sections in the intraoperative diagnosis of CNS lesions. Neuropathology. 1994;51:1-17.

Ogungbo BI, Najim O, Mendelow AD, Crawford PJ. Epidemiology of adult brain tumours in Great Britain and Ireland. British J of Neurosurg. 2002 Jan 1;16(2):140-5.

McCarthy BJ, Davis FG, Freels S, Surawicz TS, Damek DM, Grutsch J, et al. Factors associated with survival in patients with meningioma. J of Neurosur. 1998 May;88(5):831-9.

Ghosal N, Hegde AS, Murthy G, Furtado SV. Smear preparation of intracranial lesions: a retrospective study of 306 cases. Diagnostic cytopathology. 2011 Aug 1;39(8):582-92.

Sarkar C, Sharma MC, Sudha K, Gaikwad S, Varma A. A clinico-pathological study of 29 cases of gliosarcoma with special reference to two unique variants. The Ind J of Med Resea. 1997 Sep;106:229-35.

Manisha K, Pradeep M, Subimal R. Clinicopathological study of 115 cases of glioblastoma multiforme with special reference to gliosarcoma. IJPSR. 2013;39:2392.

Ohgaki H, Dessen P, Jourde B, Horstmann S, Nishikawa T, Di Patre PL, et al. Genetic pathways to glioblastoma: a population-based study. Cancer Research. 2004 Oct 1;64(19):6892-9.

Giannini C, Scheithauer BW, Burger PC, Brat DJ, Wollan PC, Lach B, O'Neill BP. Pleomorphic xanthoastrocytoma. Cancer. 1999 May 1;85(9):2033-45.

Shrestha S, Thapa BK, Bhattarai B. Smear technique for intraoperative diagnosis of central nervous system neoplasms. J of Patho of Nep. 2014 Apr 25;4(7):544-7.

Ohgaki H, Kleihues P. Epidemology and etiology of gliomas. Acta Neuropathol. 2005;109(1):93-108.

Sarat D, Rajesh KB, Ahmed A. Crush smear cytology: A rapid diagnostic technique in the intraoperative diagnosis of CNS tumors. JMSCR. 2015;3(7):6762-7.

Patil SS, Kudrimoti JK, Agarwal RD, Jadhav MV, Chuge A. Utility of squash smear cytology in intraoperative diagnosis of central nervous system tumors. J of Cytol. 2016 Oct;33(4):205.

Mitra S, Kumar M, Sharma V, Mukhopadhyay D. Squash preparation: A reliable diagnostic tool in the intraoperative diagnosis of central nervous system tumors. J Cytology/Indian Academy of Cytologists. 2010 Jul;27(3):81.