Intraoperative Squash and Touch Preparation Cytology of Brain Lesions Stained with H+E and Diff-Quik™: A 20-Year Retrospective Analysis and Comparative Literature Review

Hamasaki, Makoto; Chang, Karen; Nabeshima, Kazuki; Tauchi-Nishi, Pamela

doi:10.1159/000480063

Cited by 11 publications

(11 citation statements)

References 12 publications

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“…Generally, TIC is considered acceptable for the rapid diagnosis of brain tumors when compared to histological diagnosis [1,11]. Although a previous report examined the diagnostic concordance rate from the tumor, the present study showed 100% concordance at the macroscopical tumor, with 92.9% of specimens being determined to be A1.…”

Section: Discussioncontrasting

confidence: 55%

Touch imprint cytology is useful for the intraoperative pathological diagnosis of PitNETs

Tanabe¹,

Inoshita²,

Ishida³

et al. 2023

Preprint

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Touch imprint cytological (TIC) preparation and frozen section (FS) procedures are essential for intraoperative pathological diagnosis (IPD). They are invaluable tools for therapeutic decision-making, helping surgeons avoid under or overtreatment of patients. Pituitary neuroendocrine tumors (PitNETs) are generally small, slow-growing tumors with low-grade malignancy located at the base of the skull, where it is impossible to maintain a wide tumor margin. Therefore, transsphenoidal surgery (TSS) should be performed with necessary caution, and with sufficient and minimal resection. Thus, this study aimed to evaluate the diagnostic accuracy of TIC for the diagnosis of PitNET and determine its ability to accurately evaluate the surgical margin compared to the FS procedure. A total of 104 fresh specimens from 28 patients who underwent TSS for PitNETs were examined using TIC and FS. TIC specimens were categorized according to the cell attachment pattern. The rich and diffusely attached neuroendocrine cells were all from PitNETs. In contrast, no rich or diffuse cell attachments were observed in any non-tumoral endocrine cells. In conclusion, recognizing a pattern of endocrine cell adherence is highly effective in IPD in order to certify the existence of a PitNET component.

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Section: Discussioncontrasting

confidence: 55%

Touch imprint cytology is useful for the intraoperative pathological diagnosis of PitNETs

Tanabe¹,

Inoshita²,

Ishida³

et al. 2023

Preprint

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“…For brain tumors in people, major limitations of squash prep cytology are encountered with firm and tough or extensively necrotizing lesions that led to inadequate samples. 27 In the present study, an inadequate sample rate was not calculated. However, it is the authors' opinion that bladder carcinomas tend to be friable and suitable for squash prep cytology in almost all cases.…”

Section: Discussionmentioning

confidence: 82%

“…Squash prep cytology has already been reported to be useful in diagnosing nervous system, 22 nasal cavity, 23,24 and gastric lesions 21 in dogs. In people, squash prep cytology is mainly used to intraoperatively diagnose brain lesions, 27 demonstrating high sensitivity, specificity, and overall diagnostic accuracy. For brain tumors in people, major limitations of squash prep cytology are encountered with firm and tough or extensively necrotizing lesions that led to inadequate samples 27 .…”

Section: Discussionmentioning

confidence: 99%

“…In people, squash prep cytology is mainly used to intraoperatively diagnose brain lesions, 27 demonstrating high sensitivity, specificity, and overall diagnostic accuracy. For brain tumors in people, major limitations of squash prep cytology are encountered with firm and tough or extensively necrotizing lesions that led to inadequate samples 27 . In the present study, an inadequate sample rate was not calculated.…”

Section: Discussionmentioning

confidence: 99%

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Usefulness of squash preparation cytology in the diagnosis of canine urinary bladder carcinomas

Pierini

Criscuolo

Bonfanti³

et al. 2022

Veterinary Clinical Pathol

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Background Epithelial cells show varying degrees of cytologic atypia in dogs with nonmalignant lesions (NML) and carcinomas (ubC) of the bladder, making histopathologic examination necessary for a definitive diagnosis. Objectives This study aimed to investigate the diagnostic performance of squash preparation cytology and identify several cytomorphologic features of ubC to assist in diagnoses. Methods Squash preparations were made and reviewed in dogs that underwent transurethral cystoscopy. The results were compared with histopathologic diagnoses. Two cytopathologists performed blinded assessments using a scoring system established for 11 cytologic features, including the presence of macronuclei, abnormal nucleoli, atypical mitoses, signet ring cells, multinucleated cells, nuclear molding, anisokaryosis, cytoplasmatic microvacuolization, cell arrangements, and neutrophil and lymphocyte infiltrations. Based on cytologic and histopathologic diagnoses, dogs were divided into ubC and NML groups. Associations between cytologic and histopathologic diagnoses were investigated, and agreement between the cytopathologists was calculated. Cytologic features were analyzed with multivariate logistic regression models. The performance of predictors in the final model was evaluated in terms of Sensitivity (Se), Specificity (Sp), accuracy, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio positive (LR+), and negative (LR‐) values, and the diagnostic odds ratio (DOR). Results Forty‐four dogs diagnosed with ubC, and 17 with NML were included in the study. Cytologic and histopathologic diagnoses were significantly associated with each cytopathologist. There was an almost perfect agreement between cytopathologists (κ = 0.88). The absence of neutrophilic infiltration, the presence of multinucleated cells, and nuclear molding were associated with ubC; using a combination of these features in parallel testing resulted in Se = 0.98, Sp = 0.65, accuracy = 0.89, PPV = 0.88, NPV = 0.92, LR + =2.77, LR‐ = 0.04, and DOR = 7.7. Conclusions Squash preparation cytology could be a reliable technique to diagnose ubC in dogs. The best diagnostic combination was the absence of neutrophilic infiltration, multinucleated cells, and nuclear molding.

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“…Although it is customary in most laboratories to use the smear and frozen section techniques to complement each other, pathologists with lacking experience in cytology may be reluctant to prepare smears. However, pathologists should be aware that a better cellular detail without freezing artifacts can be obtained with the smear technique [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Challenges in the Intraoperative Consultation of Low-Grade Epilepsy-Associated Neuroepithelial Tumors by Cytomorphology in Squash Preparations

Kurtulan¹,

Bilginer²,

Söylemezoğlu³

2022

Acta Cytologica

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Introduction: Low-grade epilepsy-associated neuroepithelial tumors (LEATs) create a diagnostic challenge in daily practice and intraoperative pathological consultation (IC) in particular. Squash smears are extremely useful in IC for accurate diagnosis; however, the knowledge on cytopathologic features of LEATs is based on individual case reports. Here, we discuss the 3 most common and well-established entities of LEATs: ganglioglioma (GG), dysembryoplastic neuroepithelial tumor (DNT), and papillary glioneuronal tumor (PGNT). Methods: Thirty patients who underwent surgery for GG, DNT, and PGNT between 2001 and 2021 were collected. Squash smears prepared during intraoperative consultation were reviewed by 1 cytopathologist and an experienced neuropathologist. Results: Among the 30 tumors, 16 (53.3%) were GG, 11 (36.6%) DNT, and 3 (10%) PGNT. Cytomorphologically, all of the 3 tumor types share 2 common features such as dual cell population and vasculocentric pattern. GG smears were characteristically composed of dysplastic ganglion cells and piloid-like astrocytes on a complex architectural background of thin- to thick-walled vessels. DNT, on the other hand, showed oligodendroglial-like cells in a myxoid thin fibrillary background associated with a delicate capillary network. Common cytological features of PGNT were hyperchromatic cells with narrow cytoplasm surrounding hyalinized vessels forming a pseudopapillary pattern and bland cells with neuroendocrine nuclei dispersed in a neuropil background. Conclusion: A higher diagnostic accuracy can be obtained when squash smears are applied with frozen sections. However, it is important to integrate clinical and radiologic features of the patient as well as to know the cytopathologic features of the LEAT spectrum in the context of differential diagnosis to prevent misinterpretation in the IC.

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Intraoperative Squash and Touch Preparation Cytology of Brain Lesions Stained with H+E and Diff-Quik™: A 20-Year Retrospective Analysis and Comparative Literature Review

Cited by 11 publications

References 12 publications

Touch imprint cytology is useful for the intraoperative pathological diagnosis of PitNETs

Touch imprint cytology is useful for the intraoperative pathological diagnosis of PitNETs

Usefulness of squash preparation cytology in the diagnosis of canine urinary bladder carcinomas

Challenges in the Intraoperative Consultation of Low-Grade Epilepsy-Associated Neuroepithelial Tumors by Cytomorphology in Squash Preparations

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