Intraoperative squash Cytology of diffuse glioma not otherwise specified, of the Cerebellum

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Alexandra Kalogeraki
Dimitrios Tamiolakis
Iris Zoi
John Segredakis
Antonios Vakis


Astrocytoma, cytology, histology.


Objective: Diffuse glioma arises anywhere in the CNS, but most frequent in the cerebral hemispheres. The tumor tends to be seen in children and in younger adults aged 20-30. We report one such case in an older female patient presenting the intraoperative cytology of the tumor.

Case report: A 48-year-old female was diagnosed by MRI with a tumor of cerebellum. Cytologic material was obtained during the resection of the tumor and diagnosed cytologically as glioma.

Conclusion: This case is presented to focus the ability of the intraoperative cytology in diagnosis of the glioma, using immunocytology and confirmed by histo- immunohistology.


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1. David N. Louis, Hiroko Ohgaki, Otmar D. Wiestler, Webster K. Cavenee, Peter C. Burger, Anne Jouvet, Bernd W. Scheithauer and Paul Kleihues. The 2007 WHO Classification of Tumours of the Central Nervous System. Acta Neuropathol. 2007 Aug; 114(2): 97–109.
2. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK: WHO classification of tumours of the central nervous system, ed 4 Lyon, IARC Press, 2016
3. Komori T. The 2016 WHO Classification of Tumours of the Central Nervous System: The Major Points of Revision Neurol Med Chir (Tokyo) 2017 Jul; 57(7): 301–311
4. Martin J. van den Bent, Michael Weller, Patrick Y. Wen, Johan M. Kros, Ken Aldape, Susan Chang. A clinical perspective on the 2016 WHO brain tumor classification and routine molecular diagnostics. Neuro-Oncology 2017, 19 (5): 614–624
5. Chandana SR, Movva S, Arora M, Singh T. Primary brain tumors in adults. Am Fam Physician. 2008 May 15;77(10):1423-30.
6. Fausto J. Rodriguez, Kah Suan Lim, Daniel Bowers, and Charles G. Eberhart. Pathological and Molecular Advances in Pediatric Low Grade Astrocytoma. Annu Rev Pathol. 2013 Jan 24; 8: 361–379.
7. Parakarama T, Chandrasoma PT, Apuzzo ML. Stereotactic brain biopsy: Astrocytic neoplasms. Los Angeles California, 1989: 96-97.
8 Adams JH, Graham DI, Doyle D. London: Chapman and Hall; 1981. Brain Biopsy: the smear technique for neurosurgical biopsies; pp. 11–4
9. Kishore S, Thakur B,, Bhardwaj A, Kusum A Diagnostic accuracy of squash cytology and role of GFAP immunoexpression in glial tumors. Indian Journal of Pathology and Oncology, January-March, 2018;5(1):12-17

10. Sarkar S, Sengupta M, Datta Ch, 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.
11. Deepti Sukheeja, Shashi Singhvi, Naresh N. Rai, and Manojit Midya. A Comparative Study of Histopathology of Astrocytomas with Intraoperative Cytology with Special Reference to MIB-1 Labelling Index. J Clin Diagn Res. 2015 Aug; 9(8): EC01–EC03.
12. Louise Eisenhardt and Harvey Cushing. Diagnosis of Intracranial Tumors by Supravital Technique. Am J Pathol. 1930 Sep; 6(5): 541–552.7.
13. Pratima Savargaonkar and Peter M. Farmer. Utility of Intra-operative Consultations for the Diagnosis of Central Nervous System Lesions. Ann Clin Lab Sci Spring 2001 vol. 31 no. 2 133-139.
14. Lucien Nochomovitz, Frank Jannotta (Et Al), Mary Sidawy. Intraoperative Consultation: A Guide to Smears, Imprints, & Frozen Sections. Chicago, ASCP press. 1998: 94-95.
15. Robbins PD, Yu LL, Lee M, Stokes BA, Thomas GW, Watson P, Wong G. Stereotactic biopsy of 100 intracerebral lesions at Sir Charles Gairdner Hospital. Pathology. 1994 Oct;26(4):410-3.
16. Nasir H, and Haque AUI. Value of Touch Preparation Cytology in Intraoperative Consultation Diagnosis of Astrocytomas. International Journal of Pathology 2003; 1: 8-12.
17. 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;33(2):93–97
18. Narang V, Jacob S, Mahapatra D, Mathew JE. Intraoperative diagnosis of central nervous system lesions: Comparison of squash smear, touch imprint, and frozen section. J Cytol. 2015;32:153–8

19. S Jaiswal, M Vij, AK Jaiswal, S Behari. Intraoperative squash cytology of central nervous system lesions: a single center study of 326 cases. Diagnostic Cytopathology 2012; 40(2):104 - 112

20. Roessler K, Dietrich W, Kitz K. High Diagnostic Accuracy of Cytologic Smears of Central Nervous System Tumors. A 15-Year Experience Based on 4,172 Patients.. Acta cytologica 2002;46(4):667-74

21. Pornsuk Cheunsuchon, Atthanisa Punyashthira, Jantima Tanboon, Tumtip Sangruchi. Accuracy of Intraoperative Consultation of CentralNervous System Lesions in Siriraj Hospital. Siriraj Med J 2014;66:113-119.

22. Arpita Jindal, Himanshi Diwan, Kanwalpreet Kaur, and V. D. Sinha. Intraoperative Squash Smear in Central Nervous System Tumors and Its Correlation with Histopathology: 1 Year Study at a Tertiary Care Centre. J Neurosci Rural Pract. 2017 Apr-Jun; 8(2): 221–224.
23. Govindaraman PK, Arumugam N,Ramasamy C, Prakasam G. Role of squash smear in intraoperative consultation of central nervous system tumors. J Sci Soc 2017;44:7-14.

24. Khuroo MS, Hamdani SM, Alam SS, Sahaf BR, Dar NQ, Bhat RA. Accuracy and utility of intraoperative squash smear cytology in neurosurgical practice. Int J Med Sci Public Health 2019;8(2):130-135.

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