A Comparative Study of Squash Smear Cytology Diagnosis and Radiological Diagnosis with Histopathology in Central Nervous System Lesions

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.