IMCC Journal of Science

The Official Peer-Reviewed Journal of Iligan Medical Center College
ISSN Print: 2783-0357 | ISSN Online: 2783-0365

Diagnostic Accuracy of Intra-Operative Squash Cytology
for Spinal Lesions

Diya Bajaj, Arti Gupta, Nishtha Yadav, Avadhesh Kushwaha, Vijay Parihar, Shailendra Ratre, Jitin Bajaj, Mallika Sinha, Ketan Hedaoo, Mukesh Sharma, Jayant Patidar, M.N. Swamy


Squash cytology serves as a rapid intraoperative tool for the diagnosis of spinal lesions. However, the presence of fibrous elements and bony spicules can sometimes pose challenges to interpretation. Although another intraoperative diagnostic tool, frozen section, is available, the soft, friable nature and high-water content of tissue can hinder the preparation of good-quality frozen sections. This highlights the need to further explore the utility of squash cytology for the intraoperative diagnosis of spinal lesions. Our study emphasizes the importance of squash cytology in the diagnosis of spinal lesions. A retrospective analytical study was conducted at the Department of Neuropathology at a tertiary hospital in India. A total of 64 samples were collected for intraoperative squash cytology, followed by biopsies for histopathological correlation. Statistical analysis was performed, and various parameters like sensitivity, specificity, and diagnostic accuracy of squash cytology were calculated, with histopathology serving as the gold standard. Out of the 64 patients suspected of having spinal lesions, 39 cases (60.93%) were neoplastic. The mean age of presentation was 37.5 years, with no sex predilection. The most common spinal tumor was schwannoma (10 cases, 15.62%), followed by meningioma (6 cases, 9.37%). Concordance between squash cytology and histopathology was found in 60 cases (93.75%), with histopathology serving as the reference standard. The sensitivity, specificity, and diagnostic accuracy were 94.73%, 96.15%, and 95.31%, respectively. Squash cytology is a rapid, inexpensive, and reasonably accurate intraoperative diagnostic test for spinal lesions. When combined with clinical and radiological correlation, it demonstrates high diagnostic accuracy.

Keywords: intra-operative diagnosis; spinal cord tumors; squash cytology


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