Imtiaz Ahmad Qureshi, Shahid Jamal, Nadira Mamoon, Sajid Mushtaq, Muhammad Luqman, Muhammad Ashraf Sharif.
Cytomorphological spectrum of neurosurgical lesions by crush smears cytology.
PAFMJ Jan ;59(1):4-9.

Objective: To study the cyto-pathological appearance of intraoperative crush smears of neurosurgical biopsies after subsequent comparison with paraffin sections. Design: Observational study. Place and duration of study: The study was conducted at Armed Forces Institute of Pathology, Rawalpindi, for one year from February 2002 to February 2003. Materials and Methods: One hundred, neurosurgical biopsies were received for intraoperative consultation over a period of one year. Clinical information like age, gender, history, and CT scan or MRI findings were recorded. Crush smears were prepared, fixed in 95% alcohol and stained with rapid haematoxylin and eosin stains. Diagnosis was categorised into inflammatory, benign and malignant tumours considering the cyto-pathological features. Remaining tissue was fixed overnight in 10% formalin for histological sections. Permanent Haematoxylin and Eosin (H&E) sections were used as the “gold standard” for comparison. Results: Out of 100 neurosurgical biopsies, crush smears of 94 were considered suitable for interpretation. The smears were categorised as, 8 inflammatory, 41 benign and 41 malignant tumours. Four cases were labelled as inconclusive. Eighty four of the crush smears diagnosis agreed with the histological diagnosis, cyto-morphology of the lesions on crush smear is discussed. Conclusions: Crush smears are useful in the intraoperative diagnosis of space occupying lesions of central nervous system as majority of the cases have typical diagnostic yield and cyto-morphology. We found crush smear cytology highly reliable, rapid and inexpensive mode of intraoperative diagnosis.

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