Study of intraoperative squash cytology and frozen section diagnosis of central nervous system lesions with histopathological correlation

Abstract

Context: Intraoperative evaluation of central nervous system (CNS) lesions helps to guide the management by providing preliminary diagnosis, confirming the presence or absence of a neoplasm. Squash cytology and frozen section are reliable and sensitive techniques for rapid intraoperative diagnosis. However, both have respective limitations and the choice of the technique depends on individual preference and tissue availability. Aims: This study aims to determine the diagnostic accuracy of intraoperative squash cytology and frozen section diagnosis by correlating with the final histopathological diagnosis. Settings and Design: Prospective study over a span of 2 years in a tertiary care center. Materials and Methods: A total of 64 cases were subjected to intraoperative squash cytology and frozen section study and the intraoperative diagnosis was compared with final histopathological diagnosis. Statistical Analysis Used: Diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value. Results: Out of the 64 cases, 86% cases were neoplastic and 14% cases were non-neoplastic. The overall diagnostic accuracy of squash cytology was 90.6% and frozen section was 93.7%. Conclusion: Squash cytology and frozen section are highly accurate and reliable techniques for intraoperative frozen section evaluation of CNS lesions. However, both the techniques have respective limitations. When combined together they help improve the overall diagnostic accuracy.