Acta Cytologica
Nongynecologic Cytopathology
Utility of Squash Cytology in Spinal Lesions with Special Reference to Ki67 ImmunostainChakrabarty D.a · Chaudhuri S.b · Maity P.a · Chatterjee U.a · Ghosh S.baDepartment of Pathology, IPGME&R and SSKM Hospital, Kolkata, India
bDepartment of Neurosurgery, IPGME&R and SSKM Hospital and Bangur Institute of Neurosciences, Kolkata, India |
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Received: July 05, 2018
Accepted: April 30, 2019
Published online: June 24, 2019
Issue release date: September - October
Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 5
ISSN: 0001-5547 (Print)
eISSN: 1938-2650 (Online)
For additional information: https://www.karger.com/ACY
Abstract
Background: Squash cytology is of significant importance in intraoperative consultation of central nervous system (CNS) pathology. There are several studies on squash cytology of CNS lesions, and only a few of them deal with spinal lesions alone. Aims: (1) To evaluate intraoperative squash cytology of spinal lesions. (2) To correlate cytological diagnosis with histopathological diagnosis and assess the diagnostic accuracy. (3) To study Ki67 expression on squash smears and determine whether it can assist in grading spinal tumours on cytology. Materials and Methods: A prospective study was conducted on 68 patients with clinico-radiologically diagnosed lesions of the spine. Intraoperative squash smears were stained with haematoxylin-eosin (H&E) stain, Papanicolaou (Pap) stain, and May-Grünwald-Giemsa (MGG) stain. Subsequently, histological diagnosis was made. Ki67 immunostaining was performed on squash smears and histology sections. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of squash cytology in spinal lesions were 84.6, 100, 100, 23.1, and 80.88%, respectively. On immunocytochemistry, the mean Ki67 labelling indices for grade I, II, and III tumours were 0, 0.33 and 9%, respectively. Conclusion: Squash smear cytology is a rapid intraoperative technique for diagnosing spinal lesions, with high specificity and high positive predictive value. It is more effective in diagnosing neoplasms than non-neoplastic lesions. Ki67 immunostaining can be done on cytology smears to effectively differentiate between WHO grade I and grade II spinal tumours.
© 2019 S. Karger AG, Basel
Related Articles:
References
- Kwinta B, Adamek D, Moskała M, Stachura K. Tumours and tumour-like lesions of the spinal canal and spine. A review of 185 consecutive cases with more detailed close-up on some chosen pathologies. Pol J Pathol. 2011;62(1):50–9.
- Jaiswal S, Vij M, Jaiswal AK, Behari S. Intraoperative squash cytology of central nervous system lesions: a single center study of 326 cases. Diagn Cytopathol. 2012 Feb;40(2):104–12.
- Dikondwar AR, Dani AA, Gaikwad SA, Tathe SP, Randale AA, Chawhan SM, et al. Utility and challenges in intraoperative consultation of spinal lesions by crush smear cytology. Asian J Neurosurg. 2016 Apr-Jun;11(2):129–33.
- Goel D, Sundaram C, Paul TR, Uppin SG, Prayaga AK, Panigrahi MK, et al. Intraoperative cytology (squash smear) in neurosurgical practice - pitfalls in diagnosis experience based on 3057 samples from a single institution. Cytopathology. 2007 Oct;18(5):300–8.
-
Iqbal M, Shah A, Wani MA, Kirmani A, Ramzan A. Cytopathology of the central nervous system. Part I. Utility of crush smears cytology in intraoperative diagnosis of central nervous system lesions. Acta Cytol. 2006 Nov-Dec;50(6):608–16.
-
Shah AB, Muzumdar GA, Chitale AR, Bhagwati SN. Squash preparation and frozen section in intraoperative diagnosis of central nervous system tumors. Acta Cytol. 1998 Sep-Oct;42(5):1149–54.
External Resources
-
Asha T, Shankar SK, Rao TV, Das S. Role of squash-smear technique for rapid diagnosis of neurosurgical biopsies – a cytomorphological evaluation. Indian J Pathol Microbiol. 1989 Jul;32(3):152–60.
-
Mouriquand C, Benabid AL, Breyton M. Stereotaxic cytology of brain tumors. Review of an eight-year experience. Acta Cytol. 1987 Nov-Dec;31(6):756–64.
-
Kini JR, Jeyraj V, Jayaprakash CS, Indira S, Naik CN. Intraoperative consultation and smear cytology in the diagnosis of brain tumours. Kathmandu Univ Med J (KUMJ). 2008 Oct-Dec;6(24):453–7.
- Shukla K, Parikh B, Shukla J, Trivedi P, Shah B. Accuracy of cytologic diagnosis of central nervous system tumours in crush preparation. Indian J Pathol Microbiol. 2006 Oct;49(4):483–6.
- Sarkar S, Sengupta M, Datta C, Chatterjee U, Ghosh SN. Evaluation of Intraoperative Cytological Smears for Diagnosis of Brain Tumors with Special Reference to Immunohistochemistry. Indian J Med Paediatr Oncol. 2017 Jul-Sep;38(3):296–301.
-
Pawar N, Deshpande K, Surase S, D’Costa G. Evaluation of the Squash Smear Technique in the Rapid Diagnosis of Central Nervous System Tumors: A Cytomorphological Study. Int J Pathol. 2010;11:1–5.
-
Kishore S, Bhardwaj A, Kusum A, Thakur B, Kaushik S, Sharma N: Intraoperative squash cytology of central nervous system and spinal cord lesions with histological correlation. Ann Pathol Lab Med. 2016;3:61–72.
- Chand P, Amit S, Gupta R, Agarwal A. Errors, limitations, and pitfalls in the diagnosis of central and peripheral nervous system lesions in intraoperative cytology and frozen sections. J Cytol. 2016 Apr-Jun;33(2):93–7.
- Folkerth RD. Smears and frozen sections in the intraoperative diagnosis of central nervous system lesions. Neurosurg Clin N Am. 1994 Jan;5(1):1–18.
- Asha T, Shankar SK, Rao TV, Das S. Role of squash-smear technique for rapid diagnosis of neurosurgical biopsies—a cytomorphological evaluation. Indian J Pathol Microbiol. 1989 Jul;32(3):152–60.
- Chaudhuri PM, Chaudhuri S, Chakrabarty D, Chatterjee S, Datta C, Chaudhuri MK, et al. Squash cytology of tanycytic ependymoma: A report of two cases. Diagn Cytopathol. 2017 Mar;45(3):270–3.
- Nicácio JM, Rodrigues JC Jr, Galles MH, Faquini IV, de Brito Pereira CA, Ganau M. Cervical intramedullary schwannoma: a case report and review of the literature. Rare Tumors. 2009 Dec;1(2):e44.
- Mitra S, Kumar M, Sharma V, Mukhopadhyay D. Squash preparation: A reliable diagnostic tool in the intraoperative diagnosis of central nervous system tumors. J Cytol. 2010 Jul;27(3):81–5.
Article / Publication Details
Received: July 05, 2018
Accepted: April 30, 2019
Published online: June 24, 2019
Issue release date: September - October
Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 5
ISSN: 0001-5547 (Print)
eISSN: 1938-2650 (Online)
For additional information: https://www.karger.com/ACY
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
