Comparative study of frozen section and squash preparation for intraoperative diagnosis of CNS lesions and their correlation with paraffin sections in a tertiary care hospital, Vadodara

Abstract

Background: The main usefulness of intraoperative consultation on lesions of the CNS is to confirm or rule out the presence or absence of neoplasia and to define the neoplastic cell type and histologic grade of the tumor. Two main techniques for the intra-operative diagnosis of specimens are available: cryostat (frozen) sections and smear (squash,crush) preparations. The choice of the most suitable investigative technique depends on individual experience and preference. Aims and objectives: This study aims to assess the sensitivity / diagnostic accuracy by squash preparation and frozen section, by comparing it with paraffin sections. Materials and Methods: This study comprised of 65 cases of CNS tumours received and analysed. Intraoperative squash smears and frozen sections were prepared and intraoperative diagnosis were compared with paraffin sections. Results: Out of total 65 cases, 18 cases were of Meningioma, 12 cases were of Glial Tumour and 7 cases were of Schwannoma. Out of total 65 cases, 32 (49.23%) cases were of more than 40 years old. In the present study, male to female ratio was 0.55: 1. Sensitivity of squash method was 90.74% and of frozen section was 88.88%. Combination of both methods resulted in increased sensitivity to 94.44%. Conclusion: In conclusion, squash preparation and frozen section techniques are complementary to each other for intraoperative diagnosis of CNS lesions. Combined utility of both these methods yield high diagnostic accuracy.