Intraoperative neurocytology of primary central nervous system neoplasia

A simplified and practical diagnostic approach

Suash Sharma, Prabal Deb

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

Intraoperative consultations may pose considerable diagnostic challenge to the neuropathologist in diagnosing primary and metastatic neoplasms of the central nervous system (CNS). Cytological preparations in the form of squash, touch, imprint or smears are few of the available modalities in addition to the frozen section (FS). Although the latter is superior in providing both histologic patterns and cytomorphologic details yet smears are of vital importance when tissue available is limited (stereotactic biopsy), scrutinisation of intercellular matrix (astrocytoma versus oligodendroglioma) and evaluation of discohesive cells (lymphoma, pituitary adenoma) and in inflammatory lesions. This review is intended to emphasize the value, applicability and limitations of neurocytology aiming to expedite the intraoperative smear-based diagnoses of CNS neoplasia as per the World Health Organization (WHO) classification. We recommend that whenever possible, both smears and FS should be examined concomitantly and in a correlative manner. In the unlikely event of a mismatch between the findings on smear and FS, intraoperative diagnosis is primarily based on FS, if adequate tissue is available. However, each case must be evaluated on its own merit and in difficult cases relevant differential diagnoses should be offered to facilitate surgical decisions and optimally triage patient management.

Original languageEnglish (US)
Pages (from-to)147-158
Number of pages12
JournalJournal of Cytology
Volume28
Issue number4
DOIs
StatePublished - Oct 1 2011

Fingerprint

Frozen Sections
Central Nervous System
Neoplasms
Oligodendroglioma
Cucurbita
Central Nervous System Neoplasms
Triage
Astrocytoma
Touch
Pituitary Neoplasms
Lymphoma
Differential Diagnosis
Referral and Consultation
Biopsy

Keywords

  • Frozen section
  • intraoperative neurocytology
  • squash

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Intraoperative neurocytology of primary central nervous system neoplasia : A simplified and practical diagnostic approach. / Sharma, Suash; Deb, Prabal.

In: Journal of Cytology, Vol. 28, No. 4, 01.10.2011, p. 147-158.

Research output: Contribution to journalReview article

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