Publication:

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

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.