Optic nerve pilomyxoid astrocytoma: Intraoperative squash smear cytology of a rare entity.

Pilomyxoid astrocytoma [PMA] is a rare, recently described variant of pilocytic astrocytoma with unique clinical and histopathological characteristics. It typically affects the optico-chiasmatic and hypothalamic region in infants and young children. Though the pilocytic astrocytoma is the commonest tumor of the optic nerve, pilomyxoid astrocytoma arising from the intraorbital part of the optic nerve is extremely rare. To the best of our knowledge, only one case of introrbital optic nerve pilomyxoid astrocytoma has been described in the English literature. We report two cases of pilomyxoid astrocytoma arising from the intraorbital optic nerve, diagnosed on intraoperative squash smear cytology and later confirmed on histopathology. Like in other locations, optic nerve pilomyxoid astrocytoma behaves in an aggressive manner.

Papillary meningioma: Diagnosis by intraoperative crush smear cytology.

Papillary meningioma is a rare, aggressive variant of meningioma. It accounts for less than 1% of all meningiomas. It is categorized as WHO grade III due to high rate of recurrence and metastasis. Histopathologic features of papillary meningioma are well described, but cytomorphology is rarely been described. We report a case of papillary meningioma, diagnosed on intraoperative crush cytology and later confirmed on histopathology. Papillary meningioma possesses characteristic cytological features. Along with the cellular meningothelial features, radial arrangement of cells around thin and thick walled hyalinised blood vessels gives the diagnostic clue. In addition, knowledge of clinical and radiological features is extremely helpful to arrive at the correct diagnosis and to differentiate it from other papillary lesions involving central nervous system. Due to aggressive clinical course and poor prognosis of papillary meningioma, a timely recognition of the diagnosis is desirable and helpful for rationalizing approaches to therapy.

Intraoperative crush smear cytology of vertebral chondroblastoma: A diagnostic challenge.

Chondroblastoma is a rare, cartilage producing primary neoplasm of the bone. Although generally benign, chondroblastoma is placed in the "intermediate, rarely metastasizing" category in the 2013 World Health Organization classification of bone tumors. It typically involves the epiphysis of long tubular bones and is exceptionally located in the vertebral column. To the best of our knowledge, less than 35 cases of vertebral chondroblastoma have been reported in the literature. We report a case of chondroblastoma involving D6 -D7 vertebrae in a 17-year-old male patient, diagnosed on intraoperative crush cytology and later confirmed on histopathology. Intraoperative crush cytology is rarely been used for the diagnosis of bone lesions. Till date, this is the third case of vertebral chondroblastoma being diagnosed on cytology and first case being diagnosed on intraoperative crush smear cytology. Previous two cases were diagnosed on fine-needle aspiration cytology. Chondroblastoma possesses distinct and diagnostic cytological features, which allows correct diagnosis even in the rarer locations like vertebral column. Crush cytology can be helpful in the rapid intraoperative diagnosis of vertebral chondroblastoma leading to early proper management of the patient.

Gastric mucormycosis: Diagnosis by imprint cytology.

The fungi in the order of Mucorales commonly target diabetics and other immunocompromised hosts, producing fatal respiratory and or CNS infections. Gastrointestinal mucormycosis is uncommon and seldom diagnosed in living patients due to nonspecific clinical manifestations. We report a case of gastric mucormycosis in an immmunocompetent male patient, diagnosed by imprint cytology-a rare site and a rare setting. To the best of our knowledge, this is only the second report of gastric mucormycosis being diagnosed on cytology. As the disease is rapidly progressive and often fatal, early diagnosis is critical to the patient survival. Imprint cytology or brush cytology is extremely useful for the rapid diagnosis of gastric mucormycosis as these organisms are morphologically distinct. Familiarity with the cytomorphology of these organisms assists in the correct diagnosis of this disease. Diagn. Cytopathol. 2016;44:820-822. © 2016 Wiley Periodicals, Inc.

Utility and challenges in intraoperative consultation of spinal lesions by crush smear cytology.

BACKGROUND: Various methods are used for intraoperative consultation of spinal lesions. Crush smear cytology is one such method that is accurate, rapid, and allows preservation of tissue for paraffin-embedded sections. AIMS: To study the cytomorphology of various neoplastic and nonneoplastic lesions involving and compressing the spinal cord. To evaluate accuracy and discuss diagnostic pitfalls of crush smear cytology. MATERIALS AND METHODS: Over a period of 5 years (January 2008 to October 2012), a total of 57 spinal lesions were referred for intraoperative cytology. In four cases, material was inadequate for evaluation, so we analyzed 53 cases. RESULTS: Majority of lesions were neoplastic accounting for 86.79% whereas nonneoplastic lesions constituted 13.20%. Most of the tumors were low grade (82.92%). Overall accuracy rate was 90.56% with accuracy of 91.30% and 85.71% for neoplastic and inflammatory lesions, respectively. CONCLUSION: Crush smear technique is a simple, reliable, easy, and rapid method for diagnosing neoplastic and inflammatory lesions involving and compressing the spinal cord. It gives an immediate idea of prognosis so that surgeon can modify the operative procedure, if necessary.