Scoring system for intraoperative diagnosis of intracranial schwannoma by squash cytology.
brain tumour
intracranial schwannoma
intraoperative diagnosis
scoring system
squash cytology
Journal
Cytopathology : official journal of the British Society for Clinical Cytology
ISSN: 1365-2303
Titre abrégé: Cytopathology
Pays: England
ID NLM: 9010345
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
revised:
16
10
2021
received:
30
07
2021
accepted:
03
11
2021
pubmed:
9
11
2021
medline:
5
4
2022
entrez:
8
11
2021
Statut:
ppublish
Résumé
To assess the utility of a newly developed squash cytology (SC)-based scoring system for accurate intraoperative diagnosis of schwannoma. We first compared SC-based and frozen section (FS) diagnoses with final pathological diagnoses of schwannoma (16 cases), meningioma (39 cases) and low-grade astrocytoma (16 cases). Then, by logistic regression modeling, we identified features of SC preparations that were independently predictive of schwannoma. To develop a diagnostic scoring system, we assigned one point to each feature, and performed receiver operating characteristic analysis to determine the score cut-off value that was most discriminatory for differentiating schwannoma from the other tumour types. We then compared accuracy, sensitivity, and specificity of diagnosis before and after the application of the scoring system. Overall diagnostic concordance rates for SC and FS were almost the same, at 73.2% (52/71) and 77.5% (55/71 cases), respectively. Of the 16 SC features entered into the analysis, the following nine were found to independently predict schwannoma, and were thus incorporated into the scoring system: smooth cluster margins, few or no isolated tumour cells, fibrillary stroma, spindle-shaped nuclei, parallel arrangement of stroma, parallel arrangement of nuclei, presence of anisonucleosis, absence of nucleoli, and hemosiderin deposition. A cut-off score of four items yielded the best sensitivity, specificity and predictive values for prediction of schwannoma. Use of the scoring system improved accuracy of intraoperative diagnosis from 80.3% to 94.4%, sensitivity from 56.2% to 93.8%, and specificity from 87.3% to 94.5%. Our proposed SC-based scoring system will increase accuracy of intraoperative diagnosis of schwannoma vs non-schwannoma tumours.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
196-205Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Russell DS, Rubinstein LJ. Pathology of the Tumours of the Nervous System, 6th ed, Vol. 2. Edward Arnold; 1998.
Louis DN, Ohgaki H, Wiestler OD, Cavenee WK. WHO Classification of Tumours of the Central Nervous System. IARC; 2016.
Takei H, Schmiege L, Buckleair L, Goodman JC, Powell SZ. Intracerebral schwannoma clinically and radiologically mimicking meningioma. Pathol Int. 2005;55:514-519.
Gao Y, Qin Z, Li D, et al. Intracerebral schwannoma: a case report and literature review. Oncol Lett. 2018;16:2501-2510.
Casadei GP, Komori T, Scheithauer BW, Miller GM, Parisi JE, Kelly PJ. Intracranial parenchymal schwannoma. A clinicopathological and neuroimaging study of nine cases. J Neurosurg. 1993;79:217-222.
Goel D, Sundaram C, Paul TR, et al. Intraoperative cytology (squash smear) in neurosurgical practice - pitfalls in diagnosis experience based on 3057 samples from a single institution. Cytopathology. 2007;18:300-308.
Amraei R, Moradi A, Zham H, Ahadi M, Baikpour M, Rakhshan A. A comparison between the diagnostic accuracy of frozen section and permanent section analyses in central nervous system. Asian Pac J Cancer Prev. 2017;8:659-666.
Mitra S, Kumar M, Sharma V, Mukhopadhyay D. Squash preparation: a reliable diagnostic tool in the intraoperative diagnosis of central nervous system tumors. J Cytol. 2010;27:81-85.
Jaiswal S, Vij M, Jaiswal AK, Behari S. Intraoperative squash cytology of central nervous system lesions: a single center study of 326 cases. Diagn Cytopathol. 2012;40:104-112.
Fujita H, Tajiri T, Machida T, et al. Intraoperative squash cytology provides a qualitative intraoperative diagnosis for cases in which frozen section yields a diagnosis of equivocal brain tumor. Cytopathology. 2020;31:106-114.
Chebib I, Hornicek FJ, Nielsen GP, Deshpande V. Cytomorphologic features that distinguish schwannoma from other low-grade spindle cell lesions. Cancer Cytopathol. 2015;123:171-179.
Kobayashi S, Miki H, Ohmori M, et al. Cytodiagnosis of brain tumors by squash method-comparative study of meningiomas, neurilemmomas and astrocytomas. J Jpn Soc Clin Cytol. 1989;28:378-383.
Kanda Y. Investigation of the freely-available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013;48:452-458.
Ansari SF, Terry C, Cohen-Gadol AA. Surgery for vestibular schwannomas: a systematic review of complications by approach. Neurosurg Focus. 2012;33:E14.
Hadjipanayis CG, Carlson ML, Link MJ, et al. Congress of neurological surgeons systematic review and evidence-based guidelines on surgical resection for the treatment of patients with vestibular schwannomas. Neurosurgery. 2018;82:E40-E43.
Clark M, Westerberg BD, Akagami R, Mick P. Lateral intracanalicular growth of vestibular schwannomas and surgical planning. Otol Neurotol. 2010;31:267-270.
Patil SS, Kudrimoti JK, Agarwal RD, Jadhav MV, Chuge A. Utility of squash smear cytology in intraoperative diagnosis of central nervous system tumors. J Cytol. 2016;33:205-209.
Siddiqui MT, Mahon BM, Cochran E, Gattuso P. Cytologic features of meningiomas on crush preparations: a review. Diagn Cytopathol. 2008;36:202-206.
Roessler K, Dietrich W, Kitz K. High diagnostic accuracy of cytologic smears of central nervous system tumors. A 15-year experience based on 4,172 patients. Acta Cytol. 2002;46:667-674.
Kanehara T, Arimitsu K, Hirokawa M. Cytologic findings of schwannoma-an analysis of twenty-seven cases. J Jpn Soc Clin Cytol. 1999;38:45-49.
Samii M, Gerganov VM. Tumors of the cerebellopontine angle. Handb Clin Neurol. 2012;105:633-639.
Brunori A, Scarano P, Chiappetta F. Non-acoustic neuroma tumor (NANT) of the cerebello-pontine angle: a 15-year experience. J Neurosurg Sci. 1997;41:159-168.
Jindal A, Kaur K, Mathur K, Kumari V, Diwan H. Intraoperative squash smear cytology in CNS lesions: a study of 150 pediatric cases. J Cytol. 2017;34:217-220.
Lacruz CR, Catalina-Fernández I, Bardales RH, Pimentel J, López-Presa D, Sáenz-Santamaría J. Intraoperative consultation on pediatric central nervous system tumors by squash cytology. Cancer Cytopathol. 2015;123:331-346.
Hirabayashi K, Yasuda M, Umemura S, et al. Cytologic features of the cystic fluid of pancreatic schwannoma with cystic degeneration. A case report. J Pancreas. 2008;9:203-208.
Chen H, Zeng XW, Wu JS. Solitary fibrous tumor of the central nervous system: a clinicopathologic study of 24 cases. Acta Neurochir. 2012;154:237-248.
Kang M, Kim NR, Chung DH, Yie GT. Frozen cytology of meningeal malignant solitary fibrous tumor/hemangiopericytoma. J Pathol Transl Med. 2019;53:192-197.